经鼻肠梗阻导管在治疗粘连性肠梗阻中的应用

发布时间：2018-05-28 10:41

本文选题：粘连性肠梗阻 + 经鼻肠梗阻导管　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:探究及对比内镜下置入经鼻肠梗阻导管和普通鼻胃管在治疗粘连性肠梗阻中的有效性和推广可行性。方法:收集2014年9月-2016年11月山西医科大学第一医院、第二医院及省人民医院治疗的95例确诊为粘连性肠梗阻的患者。随机将患者分为研究组和对照组进行减压治疗,研究组是在内镜操作下置入经鼻肠梗阻导管的50例患者;对照组是应用普通鼻胃管行减压治疗的45例患者。分别比较两组患者治疗效果。结果:应用经鼻肠梗阻导管治疗的研究组患者与应用普通鼻胃管治疗的对照组患者相比较,在肠梗阻症状减轻时间、腹部影像学特征改善的时间(4.4±2.35d vs 8.6±4.7d)上显著缩短,具有统计学差异,P0.01。保守治疗成功率相比较,研究组为92.0%,对照组为46.7%,P0.01。在研究组中有8%的患者保守治疗失败行手术治疗;对照组中有53.3%的患者最终行手术治疗。既往确诊为粘连性肠梗阻的再次复发的患者,经鼻肠梗阻导管在治疗效果上较普通鼻胃管显著(95.0%vs 37.5%)。在经鼻肠梗阻导管治疗组中,患者保守治疗的是否成功与患者第一天的胃肠减压量及腹部影像学的改变相关,P0.05。结论:1、经鼻肠梗阻导管在临床上可应用于粘连性肠梗阻的治疗,而且治疗效果显著优于普通鼻胃管。2、经鼻肠梗阻导管在治疗粘连性肠梗阻中,根据胃肠减压量及腹部影像学改变情况,预测保守治疗成功率及为手术时机提供参考。3、即使存在一些潜在危险性和并发症,但是经内镜下置入经鼻肠梗阻导管较为简单可行,在临床上可大量推广使用。
[Abstract]:Objective: To explore and compare the effectiveness and popularization feasibility of endoscopic sinus obstruction catheter and ordinary nasogastric tube in the treatment of adhesive intestinal obstruction. Methods: 95 patients with adhesive intestinal obstruction treated in the first hospital of Shanxi Medical University, second hospital and the provincial people's Hospital in September 2014, -2016, were randomly selected. The study group was divided into the study group and the control group for the decompression treatment. The study group was placed in 50 patients with endoscopic sinus obstruction catheterization; the control group was 45 patients with normal nasal gastric tube decompression treatment. The results were compared with the two groups of patients. Results: patients in the study group with the nasal intestinal obstruction catheter treatment and the application of the ordinary nose. Compared with the control group in the control group of gastric tube, the time of intestinal obstruction symptom relieving, the time of the improvement of the abdominal imaging features (4.4 + 2.35d vs 8.6 + 4.7d) were significantly shortened, with statistical difference, the success rate of the conservative treatment of P0.01. was compared, the study group was 92%, the control group was 46.7%, and 8% of the P0.01. in the study group failed in the conservative treatment. Surgical treatment; 53.3% of the patients in the control group were eventually operated on. Patients who had previously been diagnosed with recurrence of adhesive ileus were significantly more effective than ordinary nasal gastric tubes (95.0%vs 37.5%). In the patients with obstruction of the nasogastric obstruction, the patient's conservative treatment was successful with the first day of the gastrointestinal tract. The changes in decompression and abdominal imaging changes. P0.05. conclusion: 1, the nasal obstruction catheter can be used clinically for the treatment of adhesive ileus, and the therapeutic effect is significantly better than that of the ordinary nasal gastric tube.2. In the treatment of adhesive intestinal obstruction through the nasal intestinal obstruction catheter, the conservative treatment is predicted according to the amount of gastrointestinal decompression and the changes in the abdominal imaging. The rate of success and the reference.3 for the time of operation, even if there are some potential risks and complications, it is simple and feasible to insert the obstruction of the nasal ileus through endoscopy, and it can be widely used in clinical practice.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R656.7

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