CAJ | 학술논문

目的：评估经鼻型肠梗阻导管治疗粘连性小肠梗阻的临床疗效。方法2012年1月—2014年8月221例入院诊断为单纯粘连性小肠梗阻的患者随机行经鼻肠梗阻导管（n=111）、鼻胃管（n=110）减压治疗。观察两组患者腹胀腹痛改善情况、胃肠减压量、肛门排气排便恢复时间、腹部立卧位X线平片示气液平面消失时间，治愈率、有效率及中转手术率等指标。结果所有患者均按要求置管成功。与鼻胃管相比，经鼻插入型肠梗阻导管组患者腹胀腹痛等腹部症状缓解时间、肛门排气排便恢复时间、气液平面消失时间均明显缩短，胃肠减压引流量显著增加。可提高患者治愈率、有效率并降低中转手术率，差异均有统计学意义（P<0.05）。结论经鼻肠梗阻导管置入术治疗粘连性小肠梗阻疗效确切，能够显著改善患者的临床症状，值得在临床中推广应用。
목적：평고경비형장경조도관치료점련성소장경조적림상료효。방법2012년1월—2014년8월221례입원진단위단순점련성소장경조적환자수궤행경비장경조도관（n=111）、비위관（n=110）감압치료。관찰량조환자복창복통개선정황、위장감압량、항문배기배편회복시간、복부립와위X선평편시기액평면소실시간，치유솔、유효솔급중전수술솔등지표。결과소유환자균안요구치관성공。여비위관상비，경비삽입형장경조도관조환자복창복통등복부증상완해시간、항문배기배편회복시간、기액평면소실시간균명현축단，위장감압인류량현저증가。가제고환자치유솔、유효솔병강저중전수술솔，차이균유통계학의의（P<0.05）。결론경비장경조도관치입술치료점련성소장경조료효학절，능구현저개선환자적림상증상，치득재림상중추엄응용。
Objective To investigate the clinical application of nasal-insertion type ileus-tube in the treatment of adhesive small intestinal obstruction. Methods A total of 221 patients with simple adhesive small intestinal obstruction, who were admitted to authors’ hospital during the period from January 2010 to Aug. 2014, were enrolled in this study. The patients were randomly divided into nasal-insertion type ileus-tube group (n=111) and nasogastric tube group (n=110). After the procedure, the patients were kept under close observation, focusing on the abdominal distention, gastrointestinal decompression amount, the recovery time of anal exhaustion and defecation, the vanishing time of intestinal air-liquid plane on erect abdominal X-ray film, etc. The cure rate, effective rate and transit-operation rate were calculated. The results were compared between the two groups. Results The tube placement operation was successfully performed in all patients. Compared with the nasogastric tube group, in the nasal-insertion type ileus-tube group the recovery time of abdominal distention, anal exhaustion and defecation and the vanishing time of intestinal air-liquid plane on erect abdominal X-ray film were obviously shorter, and the gastrointestinal decompression amount was larger. In the nasal-insertion type ileus-tube group the cure rate and effective rate were significantly increased, while the transit-operation rate was decreased; the differences between the two groups were statistically significant (P<0.05). Conclusion For the treatment of adhesive small intestinal obstruction, the placement of nasal-insertion type ileus-tube is effective and reliable. This technique can strikingly improve the clinical symptoms, therefore, it is worthy of promotion and application in clinical practice.