肠梗阻导管防治肠梗阻的临床应用进展  

Advances in clinical application of obstruction catheter in prevention and treatment of intestinal obstruction

作　　者：付俊豪 赵宁 刘博 房学东[1] 谌通 张盟 刘卓[1] Fu Junhao;Zhao Ning;Liu Bo;Fang Xuedong;Chen Tong;Zhang Meng;Liu Zhuo(Department of Gastrointestinal Colorectal and Anal Surgery,China-Japan Union Hospital,Jilin University,Changchun 130033,China)

机构地区：[1]吉林大学中日联谊医院胃肠结直肠肛门外科,长春130033

出　　处：《中华胃肠外科杂志》2021年第10期931-935,共5页Chinese Journal of Gastrointestinal Surgery

基　　金：吉林省科技发展计划自然科学基金项目(20160101034JC);吉林省科技发展计划重点科技攻关项目(20170204050SF)。

摘　　要：肠梗阻是腹部外科多发疾病之一,其防治是临床难点。外科手术虽然能解决梗阻的症状,但术后并发症较多,且容易因手术后腹腔粘连再次梗阻。肠梗阻导管小肠内固定排列术,为预防术后粘连性肠梗阻的发生提供了新思路。经肛肠梗阻导管的使用,为左半结肠恶性肠梗阻手术切除肿瘤后直接一期吻合肠管提供了可能,并能够减少术后并发症的发生。但使用过程中随之而来的相关并发症也应引起足够重视,且需进行防治。需要注意的是,使用肠梗阻导管只是对肠梗阻保守治疗的一种方式,目前并不能完全取代手术,当经鼻肠梗阻导管置管成功后3 d、导管在肠腔内仍无明显下移或置管5 d以上,肠梗阻症状无明显改善,则仍需考虑手术治疗。Intestinal obstruction is one of the most common diseases in abdominal surgery,and its prevention and treatment is a clinical difficulty.Although surgical operation can solve the symptoms of obstruction,there are many postoperative complications,and it is easy to develop re-obstruction due to postoperative abdominal adhesion.The internal fixation of small intestine with obstruction catheter provides a new idea for the prevention of postoperative adhesive bowel obstruction.The use of transanal ileus catheter provides the possibility of direct intestinal anastomosis after resection of malignant obstruction in the left hemicolon and can reduce the incidence of postoperative complications.However,sufficient attention should be paid to the related complications,and prevention and treatment should be planned.It is important to note that the use of obstruction catheter is only one of the conservative treatments for bowel obstruction,and it is not a complete replacement of surgery.Surgical treatment should still be considered,if the catheter fails to significantly move,if the obstructive symptoms do not significantly improve 5 days after catheterization.

关 键 词：肠梗阻导管 肠梗阻 预防 治疗 并发症 

分 类 号：R656.7[医药卫生—外科学]