经鼻插入型肠梗阻导管治疗恶性肠梗阻的护理  

Nursing Care of Patients with Malignant Intestinal Obstruction Treated with Transnasal Intestinal Tube Insertion

作　　者：李兵[1] 沈妙莉[1] 杨炯[1] 

机构地区：[1]上海市长宁区同仁医院,上海200050

出　　处：《当代医学》2012年第6期106-108,共3页Contemporary Medicine

摘　　要：目的评价、探讨经鼻插入型肠梗阻导管治疗恶性肠梗阻的疗效与护理要点。方法 X线引导下经鼻插入肠梗阻导管引流治疗不能手术的恶性肠梗阻211例(KPS 20～60分,中位40分),观察总的临床有效率,治愈率和并发症发生与处理情况。结果随访4～245天(平均138天),总的临床有效率与治愈率分别为92.9%(196/211)和27.5%(58/211)(P<0.05)。有209例存在不同程度的咽部不适或疼痛,不良反应的发生率为99.1%(209/211);总的并发症发生率为27.5%(58/211),包括导管阻塞23.2%(49/211)、导管脱落1.9%(4/211)、导管断裂0.1%(2/211)、肠出血0.1%(2/211)、肠穿孔0.1%(1/211),无与死亡相关的并发症。结论 X引导下经鼻-肠梗阻导管插入引流治疗不能手术的恶性肠梗阻安全、有效,但不良反应及并发症的发生率较高,规范化的护理可以进一步提高治疗效果。.Objective To assess the nursing key and effectiveness of transnasal ileus tube insertion for decompression guided by fluoroscopy in the treatment of malignant bowel obstruction. Methods The 211 cases with the median KPS scale 40（range 20- 60） were treated with ileus tube insertion through nose guided by fluoroscopy for malignant ileus obstruction, and the palliative success rates, clinical cure rate and adverse reactions or relative complications were observed. Results For all patients with malignant ileus obstruction, the palliative success rates was 92.9%（196/211）. During follow-up of 4- 245 days（mean 138 days）, the total clinical cure rate was at 27.5%（58/211）. The rate of the adverse reactions or complications was 99.1%（ 199/211）on uncomfortable pharynx feeling or pain, 23.2%（49/211）on the tube obstruction, 1.9%（4/211 ）on the tube removal, 0.1%（2/211 ） on the tube fracture, 0. I%（2/211）on bowel perforation,0.1%（2/211）on intestinal bleeding. The total rate of severe complications was 4.7%. Conclusion Transnasal ileus tube insertion for decompression guided by fluroscopy in the treatment of malignant and unacceptable bowel obstruction is safe, effective. But the adverse reactions or complications rate was higher. Standardizing nursing care can improve treatment effect to the malignant bowel obstruction

关 键 词：恶性肿瘤 肠梗阻 鼻-肠管 引流 护理 

分 类 号：R473.73[医药卫生—护理学]