摘要
目的分析数字减影血管造影(digital subtraction angiography,DSA)引导下经鼻型肠梗阻导管置入术治疗复杂性肠梗阻适宜技术的临床疗效,建立DSA引导下经鼻型肠梗阻导管置入术适宜技术推广项目的临床医学诊疗体系。方法回顾性分析2022年1月~2023年9月收治的341例复杂性肠梗阻患者,根据治疗方式分为治疗组和对照组。其中,治疗组为湖南中医药大学第一附属医院胃肠外科治疗的165例,采取DSA引导下经鼻型肠梗阻导管置入术和常规治疗;对照组176例(汉寿县人民医院胃肠外科67例,益阳市人民医院普通外科64例,宁乡市中医院普通外科45例)采取胃肠减压和常规治疗,观察两组的临床疗效。结果两组均一次性置管成功,患者耐受性良好,无消化道出血、穿孔发生,治疗组死亡4例,对照组死亡6例。治疗组总有效率为82.27%(144/165),明显高于对照组的(42.61%)(75/176),差异具有统计学意义(P<0.01)。与对照组相比,治疗组肛门排气时间、排便时间、腹胀腹痛缓解时间、恢复流食时间、拔管时间、平均住院时间具有明显优势(P<0.001)。两组并发症发生率比较,治疗组电解质紊乱、导管阻塞/脱落低于对照组,有统计学差异(P<0.05),而两组鼻咽部不适、吸入性肺炎发生率比较无统计学差异(P>0.05)。结论DSA引导下经鼻型肠梗阻导管治疗复杂性肠梗阻是一种安全、有效的治疗方式,临床疗效满意,适合推广应用。
Objective To analyze the clinical efficacy of the appropriate technology for the treatment of complex intestinal obstruction with transnasal ileus tube under the guidance of the DSA,and establish the clini-cal medical diagnosis and treatment system for the promotion project of the appropriate technology for the treat-ment of nasal intestinal obstruction with the guidance of DSA.Methods From January 2022 to September 2023,there were 341 patients suffered complex intestinal obstruction entered the study.The treatment group consisted of 165 patients treated by DSA-guided transnasal ileus tube implantation appropriate techniques and routine treatment in the Department of Gastrointestinal Surgery,the First Affiliated Hospital of Hunan University of Chinese Medicine.176 patients of the control group were treated by gastrointestinal decompression and rou-tine treatment(67 from the General Surgery Department of Yiyang People's Hospital,64 from the Gastrointesti-nal Surgery Department of Hanshou People's Hospital,and 45 from the General Surgery Department of Ningx-iang Chinese Medicine Hospital).Results Both groups of patients were successfully intubated at once with-out gastrointestinal bleeding or perforation.There were 4 deaths in the treatment group and 6 deaths in the con-trol group.The total effective rate of the treatment group was 82.27%,significantly higher than that of the con-trol group(42.61%),with a statistically significant difference(P<0.01).Compared with the control group,the treatment group had significant advantages in anal exhaust time,defecation time,relief time for abdominal distension and pain,time to first oral intake,extubation time,and average hospital stay(P<0.001).The inci-dence of electrolyte disorders and catheter obstruction/detachment in the treatment group was lower than the con-trol group(P<0.05).There was no statistically significant difference between nasopharyngeal discomfort or inha-lation pneumonia(P>0.05).Conclusion DSA-guided nasal ileus catheter treatment of complicated intestinal
作者
黄湘俊
刘建红
黄浩强
刘希钦
冯阳
李澜
王永恒
彭书旺
HUANG Xiangjun;LIU Jianhong;HUANG Haoqiang;LIU Xiqin;FENG Yang;LI Lan;WANG Yongheng;PENG Shuwang(Department of Gastrointestinal Surgery,the First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410003,Hunan,China;Department of Gastrointestinal Surgery,Hanshou People's Hospital,Hanshou 415900,Hunan,China;General Surgery Department,Ningxiang Chinese Medicine Hospital,Changsha 410699,Hunan,China;Department of Gastrointestinal Surgery,Yiyang People's Hospital,Yiyang 413001,Hunan,China)
出处
《中国现代手术学杂志》
2023年第6期439-443,共5页
Chinese Journal of Modern Operative Surgery
基金
湖南省卫生健康委适宜技术项目(202218015917)
湖南省卫生健康委重点指导课题(202304019709)。
