经鼻肠梗阻导管治疗老年机械性小肠梗阻的疗效分析  

Use of transnasal ileus catheter in elderly patients with mechanical intestinal obstruction

作　　者：张超[1] 李昂[1] 曹锋[1] 王晓辉[1] 陈新[1] 罗涛[1] 李非[1] Zhang Chao;Li Ang;Cao Feng;Wang Xiaohui;Chen Xin;Luo Tao;Li Fei(Department of General Surgery,Xuanwu Hospital of Capital Medical University,National Clinical Research Center for Geriatric Diseases,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院普通外科,国家老年疾病临床医学研究中心,北京100053

出　　处：《中华普通外科杂志》2021年第5期327-331,共5页Chinese Journal of General Surgery

基　　金：国家自然科学基金青年项目(81800483);北京市优秀人才培养资助——青年骨干个人项目(2018000020124G143)。

摘　　要：目的:探讨经鼻肠梗阻导管减压治疗老年机械性小肠梗阻的疗效。方法:回顾性分析2018年1月至2019年12月首都医科大学宣武医院收治的90例机械性小肠梗阻老年患者的临床资料,分为经鼻肠梗阻导管减压的肠梗阻导管组(40例)和经鼻胃管减压的鼻胃管组(50例)。结果:肠梗阻导管组患者留置时间为(91.0±33.5)h,短于鼻胃管组的(149.3±82.3)h,差异有统计学意义(t=3.323,P=0.002)。肠梗阻导管组的排气时间、排便时间、进食时间、X线检查气液平消失时间及结肠造影剂显影时间均短于鼻胃管组[(55.9±40.9)h比(127.6±59.1)h,t=5.149;(69.8±42.3)h比(134.9±48.4)h,t=5.371;(104.3±35.1)h比(178.3±79.8)h,t=4.297;(106.2±36.6)h比(175.8±79.1)h,t=4.050;(101.4±37.3)h比(172.4±72.9)h,t=4.407,均P<0.05]。肠梗阻导管组住院时间短于鼻胃管组、药品费用少于鼻胃管组[(8.1±3.8)d比(11.6±6.7)d,t=2.248;(8236±5451)元比(15329±9582)元,t=3.293,均P<0.05]。结论:经鼻肠梗阻导管可快速有效缓解老年人机械性小肠梗阻症状,提高保守治疗成功率,缩短住院时间。Objective To evaluate the treatment efficiency using transnasal ileus catheter in elderly patients with mechanical small intestinal obstruction.Method Ninety geriatric patients with mechanical small intestinal obstruction admitted to Xuanwu Hospital of Capital Medical University from Jan 2018 to Dec 2019 were divided into intestinal obstruction catheter group with transnasal ileus catheter insertion(n=40)and nasogastric tube group(n=50).Results The transnasal ileus catheter retained for(91.0±33.5)h significantly shorter than that in nasogastric tube group((149.3±82.3)h,t=3.323,P=0.002).Compared to nasogastric tube group,the exhaust time,defecation time,feeding time,time to gas-liquid level disappearance and time to contrast agent appearance in the colon in intestinal obstruction catheter group were significantly shorter[(55.9±40.9)h vs.(127.6±59.1)h,t=5.149;(69.8±42.3)h vs.(134.9±48.4)h,t=5.371;(104.3±35.1)h vs.(178.3±79.8)h,t=4.297;(106.2±36.6)h vs.(175.8±79.1)h,t=4.050 and(101.4±37.3)h vs.(172.4±72.9)h,t=4.407,all P<0.05].In addition,the length of hospital stay was shorter and in hospital expenses were lower[(8.1±3.8)d vs.(11.6±6.7)d,t=2.248;(8236±5451)￥vs.(15320±9582)￥,t=3.293,all P<0.05].Conclusion The use of transnasal ileus catheter was safe and effective to relieve the symptoms of mechanical small intestinal obstruction,hence improving the success rate of conservative treatment.

关 键 词：肠梗阻 导管插入术 老年人 减压 

分 类 号：R574.2[医药卫生—消化系统]