数字减影血管造影引导下经侧孔快速交换法与传统鼻胃管减压治疗粘连性肠梗阻的疗效观察  

Analysis of the therapeutic effect of digital subtraction angiography guided rapid exchange through lateral foramen and traditional nasogastric tube decompression in the treatment of adhesive intestinal obstruction

作　　者：廖甜 王永恒[1] 李澜 黄湘俊[1] LIAO Tian;WANG Yongheng;LI Lan;HUANG Xiangjun(Department of Gastrointestinal and Thyroid Vascular Surgery,the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha,Hunan 410007,China)

机构地区：[1]湖南中医药大学第一附属医院胃肠甲状腺血管外科,长沙410007

出　　处：《临床外科杂志》2024年第3期289-292,共4页Journal of Clinical Surgery

基　　金：湖南省卫生健康委2023年度科研计划课题(C202304019709)。

摘　　要：目的 观察数字减影血管造影技术(DSA)引导下经侧孔快速交换法与传统鼻胃管减压治疗粘连性肠梗阻的临床疗效。方法 2019年1月~2021年1月本院收治的粘连性肠梗阻病人84例,按随机数字表法将病人分为研究组(42例)和对照组(42例),对照组予以传统鼻胃管减压治疗,研究组予以DSA引导下经侧孔快速交换法置管减压治疗。比较两组临床疗效、恢复指标(排气时间、拔管时间、进食时间、首次排便时间、腹痛缓解时间、X线气液平面消失时间、平均住院时间)、疼痛程度(VAS评分)、生活质量(SF-36评分)的差异。结果 等级资料秩和检验显示,两组临床疗效比较差异有统计学意义(P<0.05),研究组总有效率(92.86%)高于对照组(71.43%),差异有统计学意义(P<0.05)。研究组排气时间、拔管时间、进食时间、首次排便时间、腹痛缓解时间、X线气液平面消失时间、平均住院时间分别为(78.61±20.38)小时、(80.35±20.26)小时、(82.49±21.59)小时、(88.66±23.55)小时、(3.49±0.75)天、(4.31±1.16)天和(6.53±1.1)天,对照组分别为(101.36±31.56)小时、(104.33±28.85)小时、(108.41±25.55)小时、(141.32±35.49)小时、(6.05±1.29)天、(7.29±1.32)天和(10.01±2.06)天,两组比较,差异有统计学意义(P<0.05)。重复测量方差分析结示,两组治疗后1天、治疗后3天VAS评分与治疗前比较,明显降低,且治疗后3天的VAS评分低于治疗后1天,但研究组治疗后1天、治疗后3天的VAS评分均低于对照组,差异有统计学意义(P<0.05)。两组出院时SF-36量表各因子得分与治疗前比较均升高,且研究组出院时SF-36量表各因子得分均高于对照组,差异有统计学意义(P<0.05)。结论 DSA引导下经侧孔快速交换法置管减压治疗粘连性肠梗阻可有效缓解病人疼痛程度,促进早期恢复,提高生活质量。Objective Exploring the efficacy analysis of digital subtraction angiography(DSA)guided rapid exchange through lateral foramen and traditional nasogastric tube decompression in the treatment of adhesive intestinal obstruction.Methods A total of 84 patients with adhesive ileus admitted to our hospital from January 2019 to January 2021 were prospectatively selected as the study objects,and the patients were divided into the study group(42 cases)and the control group(42 cases)according to the random number table method.The control group was treated with traditional nasogastric tube decompression,and the study group was treated with DSA-guided tube decompression via lateral foraminal rapid exchange.Compare the differences in efficacy,recovery indicators(exhaust time,extubation time,eating time,first defecation time,abdominal pain relief time,X gas liquid level disappearance time,average hospitalization time),pain degree(VAS score),and quality of life(SF-36 score)between the two groups.Results Rank-sum test of hierarchical data showed that the difference in clinical efficacy between the two groups was statistically significant(P<0.05),and the total effective rate of the study group(92.86%)was higher than that of the control group(71.43%),which was statistically significant(P<0.05).In the study group,the time of exhaustion,extubation time,feeding time,first defecation time,abdominal pain relief time,X-ray gas-liquid plane disappearance time,and mean hospitalization time were(78.61±20.38)hours,(80.35±20.26)hours,(82.49±21.59)hours,(88.66±23.55)hours,(3.49±0.75)days,(4.31±1.16)days,and(6.53±1.10)days in the study group,respectively.The control group was(101.36±31.56)hours,(104.33±28.85)hours,(108.41±25.55)hours,(141.32±35.49)hours,(6.05±1.29)days,(7.29±1.32)days and(10.01±2.06)days,respectively.The difference between the two groups was statistically significant(P<0.05).Repeated-measures ANOVA results showed that the VAS scores of the two groups were significantly lower at 1 day after treatment and 3 days af

关 键 词：粘连性肠梗阻 数字减影血管造影技术 经侧孔快速交换法 传统鼻胃管减压 疗效 

分 类 号：R574.2[医药卫生—消化系统]