肠梗阻导管联合大承气汤治疗恶性肠梗阻的疗效观察  

Curative effect of ileus tube combined with Dachengqi decoction on malignant bowel obstruction

作　　者：牟东[1] 周德江[1] 陈备金 

机构地区：[1]成都军区总医院消化内科,成都610083

出　　处：《西南国防医药》2014年第7期727-729,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的：观察肠梗阻导管联合大承气汤对恶性肠梗阻的疗效。方法2011年1月-2013年8月收治的恶性肠梗阻患者75例随机分成3组。各组在禁食水、反复清洁灌肠、抗感染、纠正水电解质和酸碱平衡紊乱、全胃肠外营养常规治疗基础上，对照Ⅰ组25例采用鼻导管治疗，对照Ⅱ组25例采用肠梗阻导管治疗，观察组25例采用大承气汤联合肠梗阻导管治疗。观察治疗3 d 和7 d 后，腹胀、腹痛例数，腹围缩小程度、累计胃肠减压量以及腹胀、腹痛缓解时间、恢复排气时间、气液平面消失时间、临床疗效。结果观察组治疗3 d 及治疗7 d 后，较两个对照组腹痛、腹胀例数均有明显减少（P ﹤0.05），腹围缩小程度及胃肠累积减压量明显增加（P ﹤0.05）；观察组的腹胀、腹痛缓解时间、排气恢复时间及气液平消失时间均短于两个对照组（P ﹤0.05）；在治愈率及总有效率上，观察组明显高于两个对照组（P ﹤0.05）。治疗7 d 后，对照Ⅱ组的临床症状缓解率及总有效率均好于对照Ⅰ组（P ﹤0.05）。结论恶性肠梗阻患者用肠梗阻导管联合大承气汤后，可使肠道功能及早得到恢复，促进肠蠕动及毒素排出，缩短患者的住院时间，提高其生活质量，值得临床应用。Objective To observe the curative effect of ileus tube combined with Dachengqi decoction on malignant bowel obstruction. Methods 75 cases with malignant bowel obstruction hospitalized in the period from Jan. ,2011 to Aug. ,2013 were randomly divided into 3 groups：observation group,control group Ⅰ and control group Ⅱ,25 cases in each;routine treatment was performed to all the cases in the 3 groups,while nasogastric tube therapy was added to cases in control group Ⅰ,ileus tube therapy to cases in control group Ⅱ and ileus tube therapy combined with Dachengqi decoction to cases in observation group;at the time point of the 3rd day and the 7th day after treatment,observation was made to the following items in all the cases：the case number of abdominal distension and abdominal pain,the decrease of abdominal circumference,the cumulative amount of gastrointestinal decompression,the releasing time of abdominal distension and pain,the time of recovery of exhausting,the disappearing time of liquid and gas and the clinical curative effect. Results At the 3rd day and the 7th day after treatment,the case number of abdominal pain and distension in observation group was smaller than those in the 2 control groups（P ﹤ 0. 05）,while its decrease of abdominal circumference and the cumulative amount of gastrointestinal decompression were greater than those in the 2 control groups（P ﹤ 0. 05）;the releasing time of abdominal distension and pain,the time of recovery of exhausting,the disappearing time of liquid and gas in observation group were shorter than those in the 2 control groups（P ﹤ 0. 05）;the cure rate and the total effective rate in observation group were obviously higher than those in the 2 control groups（P ﹤ 0. 05）;at the 7th day after treatment,the rate of clinical symptom releasing and the total effective rate in control group Ⅱ were higher than that in control group Ⅰ. Conclusions Ileus tube combined with Dachengqi decoction for malignant bowel obstruction can obtain an earlier recov

关 键 词：肠梗阻 减压管 大承气汤 恶性 疗效 

分 类 号：R574.2[医药卫生—消化系统]