經鼻型腸梗阻導管在急性腸梗阻治療中的應用研究_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 張曉征 ,  桑暢野

北京市延慶區醫院普外科（北京 102100）;

Corresponding?author：

桑暢野, Email: sangchangye@126.com

Keywords：

急性腸梗阻; 經鼻型腸梗阻導管; 療效

DOI：

10.7507/1007-9424.20160380

Video：

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目的探討經鼻型腸梗阻導管對急性腸梗阻的療效。方法回顧性收集2013年6月至2015年6月期間筆者所在醫院收治的87例急性腸梗阻患者的臨床資料，根據治療分為觀察組44例（采用經鼻型腸梗阻導管治療）和對照組43例（采用普通鼻胃管治療），比較2組患者的療效以評判經鼻型腸梗阻導管在急性腸梗阻治療中的應用價值。結果總體而言，觀察組的療效優于對照組（P=0.04）。觀察組的腹痛腹脹緩解時間、肛門排氣排便緩解時間及腹部X線平片示腸梗阻緩解時間均短于對照組（P＜0.05），且48 h內腹痛腹脹緩解率、置管第1天引流量、24 h腹圍縮小量及24 h內胃腸減壓量均高于對照組（P＜0.05）。結論經鼻型腸梗阻導管可有效引流腸內容物，較早緩解腹痛、腹脹等癥狀，為進一步的手術治療創造了良好的條件，具有重要的推廣應用價值。

Citation： 張曉征, 桑暢野. 經鼻型腸梗阻導管在急性腸梗阻治療中的應用研究. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(12): 1506-1509. doi: 10.7507/1007-9424.20160380 Copy

1.	彭寶崗, 梁力建, 胡文杰, 等.生長抑素治療腸梗阻的臨床研究.中華胃腸外科雜志, 2004, 7(6):474-476.
2.	Jackson PG, Raiji MT. Evaluation and management of intestinal obstruction. Am Fam Physician, 2011, 83(2):159-165.
3.	Kitahara A, Sato S, Koike T, et al. Fatal respiratory failure developed during chemotherapy for diffuse large B cell lymphoma that occurred late after lung transplantation. Kyobu Geka, 2016, 69(11):941-945.
4.	Hayanga AJ, Bass-Wilkins K, Bulkley GB. Current management of small-bowel obstruction. Adv Surg, 2005, 39(74):1-33.
5.	Gowen GF. Long tube decompression is successful in 90% of patients with adhesive small bowel obstruction. Am J Surg, 2003, 185(6):512-515.
6.	Inoue N, Nagaike K, Ishihara S, et al. Improved balloon-tipped trans-anal ileus tube. Dig Endosc, 2006, 18(2):134-137.
7.	Takumi S, Akio H, Tadao I, et al. Significance of long tube management and timing of surgical operation for conservative treatment of adhesion ileus. Jap J Gastroenterol Surg, 2005, 38(9):1414-1419.
8.	田國偉, 張從雨, 鄭小超, 等.甘露醇聯合腸梗阻導管治療粘連性腸梗阻的臨床研究.安徽醫藥, 2011, 15(8):1017-1019.
9.	Henne-Bruns D, L?hnert M. Current status of diagnosis and nono-perative therapy of small bowel ileus. Chirurg, 2000, 71(5):503-509.
10.	田春江, 李國華.經鼻型腸梗阻導管應用進展.中國中西醫結合外科雜志, 2014, 15(5):571-573.
11.	徐小爐, 陳勇強, 耿全群, 等. X線下經鼻型腸梗阻導管治療腸梗阻的臨床應用.中華全科醫學, 2013, 63(5):790-792.
12.	Kanno Y, Hirasawa D, Fujita N, et al. Long intestinal tube insertion with the ropeway method facilitated by a guidewire placed by transnasal ultrathin endoscopy for bowel obstruction. Dig Endosc, 2009, 21(3):196-200.
13.	金殷植, 王清, 張海燕.經鼻型腸梗阻導管應用的研究現狀.醫學綜述, 2012, 25(21):3617-3619.
14.	吳階平, 裘法祖.黃家馴外科學.第6版.北京:人民衛生出版社, 2002:1067-1077.
15.	Valkodai RR, Gurusami R, Duraisami V. Postoperative adhesive intestinal obstruction:the role of intestinal stenting. Indian Assoc Pediatr Surg, 2012, 17(1):20-22.
16.	黎介壽.改善粘連性腸梗阻的手術質量.中國實用外科雜志, 2000, 20(8):450-452.
17.	Kanno Y, Hirasawa D, Fujita N, et al. Long-tube insertion with the ropeway method facilitated by a guidewire placed by transnasal ultra-thin endoscopy for bowel obstruction:a prospective, randomized, controlled trial. Gastrointest Endosc, 2009, 69(7):1363-1368.
18.	Sakakibara T, Harada A, Ishikawa T, et al. Parameter predicting the recurrence of adhesive small bowel obstruction in patients managed with a long tube. World J Surg, 2007, 31(1):80-85.

1. 彭寶崗, 梁力建, 胡文杰, 等.生長抑素治療腸梗阻的臨床研究.中華胃腸外科雜志, 2004, 7(6):474-476.
2. Jackson PG, Raiji MT. Evaluation and management of intestinal obstruction. Am Fam Physician, 2011, 83(2):159-165.
3. Kitahara A, Sato S, Koike T, et al. Fatal respiratory failure developed during chemotherapy for diffuse large B cell lymphoma that occurred late after lung transplantation. Kyobu Geka, 2016, 69(11):941-945.
4. Hayanga AJ, Bass-Wilkins K, Bulkley GB. Current management of small-bowel obstruction. Adv Surg, 2005, 39(74):1-33.
5. Gowen GF. Long tube decompression is successful in 90% of patients with adhesive small bowel obstruction. Am J Surg, 2003, 185(6):512-515.
6. Inoue N, Nagaike K, Ishihara S, et al. Improved balloon-tipped trans-anal ileus tube. Dig Endosc, 2006, 18(2):134-137.
7. Takumi S, Akio H, Tadao I, et al. Significance of long tube management and timing of surgical operation for conservative treatment of adhesion ileus. Jap J Gastroenterol Surg, 2005, 38(9):1414-1419.
8. 田國偉, 張從雨, 鄭小超, 等.甘露醇聯合腸梗阻導管治療粘連性腸梗阻的臨床研究.安徽醫藥, 2011, 15(8):1017-1019.
9. Henne-Bruns D, L?hnert M. Current status of diagnosis and nono-perative therapy of small bowel ileus. Chirurg, 2000, 71(5):503-509.
10. 田春江, 李國華.經鼻型腸梗阻導管應用進展.中國中西醫結合外科雜志, 2014, 15(5):571-573.
11. 徐小爐, 陳勇強, 耿全群, 等. X線下經鼻型腸梗阻導管治療腸梗阻的臨床應用.中華全科醫學, 2013, 63(5):790-792.
12. Kanno Y, Hirasawa D, Fujita N, et al. Long intestinal tube insertion with the ropeway method facilitated by a guidewire placed by transnasal ultrathin endoscopy for bowel obstruction. Dig Endosc, 2009, 21(3):196-200.
13. 金殷植, 王清, 張海燕.經鼻型腸梗阻導管應用的研究現狀.醫學綜述, 2012, 25(21):3617-3619.
14. 吳階平, 裘法祖.黃家馴外科學.第6版.北京:人民衛生出版社, 2002:1067-1077.
15. Valkodai RR, Gurusami R, Duraisami V. Postoperative adhesive intestinal obstruction:the role of intestinal stenting. Indian Assoc Pediatr Surg, 2012, 17(1):20-22.
16. 黎介壽.改善粘連性腸梗阻的手術質量.中國實用外科雜志, 2000, 20(8):450-452.
17. Kanno Y, Hirasawa D, Fujita N, et al. Long-tube insertion with the ropeway method facilitated by a guidewire placed by transnasal ultra-thin endoscopy for bowel obstruction:a prospective, randomized, controlled trial. Gastrointest Endosc, 2009, 69(7):1363-1368.
18. Sakakibara T, Harada A, Ishikawa T, et al. Parameter predicting the recurrence of adhesive small bowel obstruction in patients managed with a long tube. World J Surg, 2007, 31(1):80-85.

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