经鼻型肠梗阻导管在急性麻痹性肠梗阻治疗中的应用价值  

Application of naso-intestinal decompression tubes in patients with acute paralytic intestinal obstruction

作　　者：康春博 刘金洪[1,2] 李旭斌 林大鹏[1,2] 叶博 李小伟[1,2] 陈秀峰 刘庆良[1,2] 张鹏 李铎[1,2] 

机构地区：[1]北京大学航天临床医学院 [2]航天中心医院微创胃肠外科,北京市100049

出　　处：《世界华人消化杂志》2013年第24期2470-2474,共5页World Chinese Journal of Digestology

摘　　要：目的:探讨经鼻型肠梗阻导管在急性麻痹性肠梗阻治疗中的应用价值.方法:回顾性分析2010-11/2013-03 48例急性麻痹性肠梗阻患者,其中21例(治疗组,n=21)在胃镜引导下将(经鼻型)肠梗阻导管放置空肠上端后行胃肠减压治疗;27例(对照组,n=27)以传统的鼻胃管行常规胃肠减压治疗.对比分析两组患者的胃肠引流量、腹围减少、减压管留置时间、住院时间、导管阻塞率、死亡率.结果:治疗组引流量、腹围减少(926 mL±243 mL,12.6 cm±4.1 cm)均明显高于对照组(337 mL±107 mL,5.4 cm±3.5 cm,P<0.05).治疗组的导管阻塞率、气液平面消失时间、住院时间(4.8%,8.3 d±3.9 d,12.1 d±4.8 d)明显低于对照组(40.7%,13.4 d±5.6 d,17.5 d±6.1 d,P<0.05).两组患者的死亡率无明显差异(4.76%vs 7.40%,P>0.2).结论:经鼻型肠梗阻导管对急性麻痹性肠梗阻患者的治疗效果确切,优于传统的鼻胃管.AIM： To explore the use of naso-intestinal de- compression tubes （NDTs） in patients with acute paralytic intestinal obstruction. METHODS： Clinical data for 48 patients with acute paralytic intestinal obstruction treated from November 2010 to March 2013 were retrospec- tively analyzed. NDTs were placed under gastro- scopic guidance to the upper jejunum to conduct gastrointestinal decompression in 21 cases （treat- ment group）, and traditional nasal gastric tubes were placed to perform conventional gastrointes- tinal decompression in 27 cases （control group）. Gastrointestinal drainage volume, waist circum- ference reduction, indwelling time, length of hos- pital stay, catheter obstruction rate and mortality rate were compared between the two groups.RESULTS： Drainage volume （926 mL ± 243 mL vs 926 mL ± 243 mL, P 〈 0.05） and waist circum- ference reduction （12.6 cm ± 4.1 cm vs 5.4 cm ± 3.5 cm, P 〈 0.05） were significantly more in the treatment group than in the control group. The rate of catheter obstruction （4.8% vs 40.7%, P 〈 0.05）, indwelling time （8.3 d ± 3.9 d vs 13.4 d ± 5.6 d, P 〈 0.05）, and hospitalization time （12.1 d ± 4.8 d vs 17.5 d ± 6.1d, P 〈 0.05） were significantly lower in the treatment group than in the con- trol group. No significant difference was found in mortality between the two groups （4.76% vs 7.40%, P 〉 0.05）. CONCLUSION： NDTs are superior to traditional nasogastric tubes in the management of acute paralytic intestinal obstruction.

关 键 词：麻痹性肠梗阻 经鼻型肠梗阻导管 

分 类 号：R656.7[医药卫生—外科学]