低位癌性肠梗阻应用肠梗阻导管行结肠冲洗方法改进及效果分析.docVIP

低位癌性肠梗阻应用肠梗阻导管行结肠冲洗方法的改进及效果分析 　　[摘要] 目的 探讨肠梗阻置管在低位性癌性肠梗阻患者结肠冲洗方法的改进及效果。方法 将64例低位性癌性肠梗阻患者在内镜下置入经肛型肠梗阻导管进行结肠冲洗的次数和量进行动态调节与定时定量的冲洗方法进行比较。结果 两种冲洗方法在缓解患者的腹痛腹胀所需时间、腹围的缩小的速度和每日引流量均有显著性意义（P〈0.01）。结论 应用肠梗阻导管进行结肠冲洗，冲洗中注意动态掌握好冲洗的量和次数，保持引流通畅，及时排除堵塞，严密观察有无肠穿孔、肠壁坏死以及肠穿孔所致的腹腔感染症状，就可及时缓解患者的肠梗阻症状，缩短肠道准备时间、患者住院时间，也间接地提高了患者的术后生存质量。 　　[关键词]低位性肠梗阻； 肠梗阻导管； 留置导管； 结肠冲洗 　　[中图分类号] R574.2[文献标识码] A[文章编号] 1005-0515（2011）-02-013-02 　　 　　Cancer ileus application obstruction catheter line colon flush the improvement methods and effect analysis 　　HeShunQiong 　　（Affiliated Hospital, Sichuan Academy of Medical Sciences Chengdu, Sichuan 610110，China） 　　[Abstract] Objective to explore the catheter obstruction in the low post carcinoma ileus patients colon flush the improvement methods and effects. Methods 64 cases with low carcinoma ileus patients in endoscopic placing the anus for colon obstruction catheter flush type in the number and volume of dynamic adjustment and timing of quantitative irrigation are compared. Results two kinds of irrigation in alleviating the time needed for patients with abdominal distention GTTS miniature speed and daily lead flow are significant (P 0.01). Conclusions Using catheter for colon obstruction, rinse rinse rinse attention in dynamic mastering the quantity and frequency, maintain drainage unblocked, promptly eliminate jams, without close observation of the bowel perforation, bowel wall necrosis and bowel perforation caused celiac infection symptoms, can alleviate in time patients of intestinal obstruction symptoms, shorten the bowel preparation time, in-hospital time, also indirectly to improve the patients postoperative live quality. 　　[Keywords]low ileus indwelling catheter colon obstruction catheter flushing 　　 　　低位性肠梗阻是指回肠末端以及结肠的梗阻[1］。不明原因的低位性肠梗阻是外科老年患者左半结肠癌的常见症状，而结直肠癌性肠梗阻多为急性完全性。随着肿瘤发病率的上升，结直肠癌导致的低位性肠梗阻也在逐年上升，传统治疗方法一般是先急诊行梗阻近端结肠造口[2］，待患者全身情况改善后再Ⅱ期行肿瘤切除根治术，以及造口还纳术。近年来使用经肛型肠梗阻导管行结肠冲洗使肠梗阻患者的症状很快得到缓解，缓解后配合胃肠营养治疗，为结直肠肿瘤Ⅰ期根治做好了充分的肠道准备并垫定了良好的基础。我院2007年7月以来