经鼻型肠梗阻导管联合早期肠内营养治疗黏连性肠梗阻的临床疗效观察
|
摘要
目的:观察经鼻型肠梗阻导管联合早期肠内营养治疗黏连性肠梗阻的临床疗效。方法:选择2016年1—12月广西右江民族医学院附属医院胃肠外科收治的60例黏连性肠梗阻患者,按随机数字表法分为治疗组(30例)和对照组(30例)。对照组给予常规治疗,治疗组在对照组的基础上给予经鼻型肠梗阻导管联合早期肠内营养治疗,比较两组患者治疗前、后的营养学指标、免疫学指标、临床治疗指标的变化情况,以及治疗后的临床疗效和不良反应发生情况。结果:治疗组总有效率显著高于对照组(P<0.05)。治疗7d后,治疗组患者的各项营养学指标(血清前白蛋白、白蛋白、转铁蛋白及体重)及各项免疫学指标(血清CD3+、CD_4~+、CD_8~+、CD_4~+/CD_8~+)均明显高于对照组(均P<0.05)。治疗组首次排气时间、首次排便时间、腹痛缓解时间及住院时间明显短于对照组(均P<0.05)。在治疗期间,两组均未出现严重的不良反应事件。结论:经鼻型肠梗阻导管联合早期肠内营养可有效改善黏连性肠梗阻患者的营养状况和临床症状,有利于提高患者免疫力及预后,值得临床推广应用。
Objective:To investigate the clinical efficacy of transnasal intestinal obstruction combined with early enteral nutrition in the treatment of adhesive intestinal obstruction.Methods:Sixty patients with adhesive intestinal obstruction admitted in our hospital from January 2016 to December 2016 were selected,and randomly divided into a treatment group and a control group,with 30 cases in each group.The patients in the control group received conventional therapy,and those in the treatment group were treated as the control group with addition of nasal intestinal obstruction combined with early enteral nutrition.The nutritional indexes,immunological indexes,clinical effective rate and the incidence of adverse reactions were compared.Results:After 7 days of treatment,the nutritional indexes including prealbumin,serum albumin,transferrin and body weight,the immunological indexes(CD3+,CD_4~+,CD_8~+,CD_4~+/CD_8~+)and the total response rate in the observation group were significantly higher than those in the control group(P<0.05).The time of first deflation,first defecation,abdominal pain relief and hospital days in the observation group were significantly shorter than those in the control group(P<0.05).During the treatment period,no serious adverse reaction was found in both groups.Conclusion:Transnasal intestinal obstruction combined with early enteral nutrition could effectively improve the nutritional status,clinical symptoms and immune system,and might be beneficial to improve the prognosis of patients with adhesive intestinal obstruction.
Objective:To investigate the clinical efficacy of transnasal intestinal obstruction combined with early enteral nutrition in the treatment of adhesive intestinal obstruction.Methods:Sixty patients with adhesive intestinal obstruction admitted in our hospital from January 2016 to December 2016 were selected,and randomly divided into a treatment group and a control group,with 30 cases in each group.The patients in the control group received conventional therapy,and those in the treatment group were treated as the control group with addition of nasal intestinal obstruction combined with early enteral nutrition.The nutritional indexes,immunological indexes,clinical effective rate and the incidence of adverse reactions were compared.Results:After 7 days of treatment,the nutritional indexes including prealbumin,serum albumin,transferrin and body weight,the immunological indexes(CD3+,CD_4~+,CD_8~+,CD_4~+/CD_8~+)and the total response rate in the observation group were significantly higher than those in the control group(P<0.05).The time of first deflation,first defecation,abdominal pain relief and hospital days in the observation group were significantly shorter than those in the control group(P<0.05).During the treatment period,no serious adverse reaction was found in both groups.Conclusion:Transnasal intestinal obstruction combined with early enteral nutrition could effectively improve the nutritional status,clinical symptoms and immune system,and might be beneficial to improve the prognosis of patients with adhesive intestinal obstruction.
引文
[1]ZHAO R,SHI W,YU J,et al.Completeintestinal obstruction and necrosis as a complication of a ventriculoperitoneal shunt in children:a report of 2cases and systematic literature review[J].Medicine,2015,94(34):e1375.
[2]CERESOLI M,COCCOLINI F,CATENA F,et al.Water-soluble contrast agent in adhesive small bowel obstruction:a systematic review and meta-analysis of diagnostic and therapeutic value[J].American Journal of Surgery,2016,211(6):1114-1125.
[3]LI M,REN J,ZHU W,et al.Long intestinal tube splinting really prevents recurrence of postoperative adhesive small bowel obstruction:a study of 1,071cases[J].A-merican Journal of Surgery,2015,209(2):289.
[4]张居元,周振理,张楠,等.经鼻型肠梗阻导管联合复方大承气汤治疗黏连性肠梗阻56例[J].江西中医药,2015,46(10):42-43.
[5]李畅,陈林,孟祥博,等.内镜下经鼻型肠梗阻导管在黏连性肠梗阻中的应用[J].中华腔镜外科杂志,2016,9(3):136-138.
[6]何红迅.经鼻型肠梗阻导管减压在腹部术后黏连性肠梗阻治疗中的作用观察[J].医药卫生,2015,1(7):21.
[7]蒋万里.经鼻型肠梗阻导管联合防黏连汤治疗黏连性肠梗阻的效果分析[J].河南医学研究,2015,24(8):89-90.
[8]ARDESHIRPOUR F,MCCARN K E,MCKINNEYA M,et al.Computed tomography scan does not correlate with patient experience of nasal obstruction[J].Laryngoscope,2016,126(4):820-825.
[9]李畅,陈林,孟祥博,等.内镜下经鼻型肠梗阻导管在黏连性肠梗阻中的应用[J].中华腔镜外科杂志,2016,9(3):136-138.
[10]JOVANI M,ANDERLONI A,REPICI A.An unexpected cause of intestinal obstruction in an uncommon site[J].Gastroenterology,2015,148(2):304.
[11]孙强.经鼻插入型肠梗阻导管治疗黏连性小肠梗阻患者的临床效果[J].介入放射学杂志,2015,33(5):117-118.
[12]CLERMIDI P,ABADIE V,CAMPEOTTO F,et al.Sigmoidvolvulus:an underestimated cause of intestinal obstruction in Cornelia de Lange syndrome[J].Journal of Pediatrics,2015,167(4):941.
[13]PATEL V A,CARR M M.Congenital nasal obstruction in infants:a retrospective study and literature review[J].International Journal of Pediatric Otorhinolaryngology,2017(99):78.
[14]何志刚,汪霖,马敏俊,等.经鼻型肠梗阻导管联合通腑清肠汤保留灌肠治疗黏连性肠梗阻的临床研究[J].全科医学临床与教育,2017,15(2):205-207.
[15]HAN B,SHENG B,ZHANG Z,et al.Arylhydrocarbon receptor activation in intestinal obstruction ameliorates intestinal barrier dysfunction via suppression of MLCK-MLC phosphorylation pathway[J].Shock,2016,46(3):319.
[16]卢勇,郭敏慧,毕铁男,等.肠梗阻导管联合早期肠内营养对黏连性肠梗阻的治疗效果观察[J].中华全科医学,2017,15(5):879-882.
[2]CERESOLI M,COCCOLINI F,CATENA F,et al.Water-soluble contrast agent in adhesive small bowel obstruction:a systematic review and meta-analysis of diagnostic and therapeutic value[J].American Journal of Surgery,2016,211(6):1114-1125.
[3]LI M,REN J,ZHU W,et al.Long intestinal tube splinting really prevents recurrence of postoperative adhesive small bowel obstruction:a study of 1,071cases[J].A-merican Journal of Surgery,2015,209(2):289.
[4]张居元,周振理,张楠,等.经鼻型肠梗阻导管联合复方大承气汤治疗黏连性肠梗阻56例[J].江西中医药,2015,46(10):42-43.
[5]李畅,陈林,孟祥博,等.内镜下经鼻型肠梗阻导管在黏连性肠梗阻中的应用[J].中华腔镜外科杂志,2016,9(3):136-138.
[6]何红迅.经鼻型肠梗阻导管减压在腹部术后黏连性肠梗阻治疗中的作用观察[J].医药卫生,2015,1(7):21.
[7]蒋万里.经鼻型肠梗阻导管联合防黏连汤治疗黏连性肠梗阻的效果分析[J].河南医学研究,2015,24(8):89-90.
[8]ARDESHIRPOUR F,MCCARN K E,MCKINNEYA M,et al.Computed tomography scan does not correlate with patient experience of nasal obstruction[J].Laryngoscope,2016,126(4):820-825.
[9]李畅,陈林,孟祥博,等.内镜下经鼻型肠梗阻导管在黏连性肠梗阻中的应用[J].中华腔镜外科杂志,2016,9(3):136-138.
[10]JOVANI M,ANDERLONI A,REPICI A.An unexpected cause of intestinal obstruction in an uncommon site[J].Gastroenterology,2015,148(2):304.
[11]孙强.经鼻插入型肠梗阻导管治疗黏连性小肠梗阻患者的临床效果[J].介入放射学杂志,2015,33(5):117-118.
[12]CLERMIDI P,ABADIE V,CAMPEOTTO F,et al.Sigmoidvolvulus:an underestimated cause of intestinal obstruction in Cornelia de Lange syndrome[J].Journal of Pediatrics,2015,167(4):941.
[13]PATEL V A,CARR M M.Congenital nasal obstruction in infants:a retrospective study and literature review[J].International Journal of Pediatric Otorhinolaryngology,2017(99):78.
[14]何志刚,汪霖,马敏俊,等.经鼻型肠梗阻导管联合通腑清肠汤保留灌肠治疗黏连性肠梗阻的临床研究[J].全科医学临床与教育,2017,15(2):205-207.
[15]HAN B,SHENG B,ZHANG Z,et al.Arylhydrocarbon receptor activation in intestinal obstruction ameliorates intestinal barrier dysfunction via suppression of MLCK-MLC phosphorylation pathway[J].Shock,2016,46(3):319.
[16]卢勇,郭敏慧,毕铁男,等.肠梗阻导管联合早期肠内营养对黏连性肠梗阻的治疗效果观察[J].中华全科医学,2017,15(5):879-882.