Clinical Application Of Ileus Tube In The Treatment Of Adhesive Intestinal Obstruction

Intestinal obstruction is one of the common and frequently-occurring diseases in general surgery, which has fast and complex changes in physiological and pathological features and has brought certain difficulties to the surgical treatment. We should base on different types of intestinal obstruction and general state of patients to take different measures in treatment. Adhesive intestinal obstruction which accounts for 30%~60% in total cases of acute intestinal obstruction, has jumping to the first place and become the key point in further enhancing and improving the diagnosis, treatment and prevention of adhesive intestinal obstruction. Surgical treatment has always been the most effective method of treatment in adhesive intestinal obstruction; however the recurrence of intestinal obstructions caused by postoperative adhesions has always been the trouble of general surgeons. With the development of technologies associated in medical and biological materials, as well as clinical adoption of catheter, it will prevent more patients from surgery and more and more patients will be cured by conservative treatment, it can not only reduce the operation rate of adhesive intestinal obstruction, but also avoid postoperative intestinal obstruction caused by surgery, and finally can significantly improve the patients quality of life. This study selected 80 cases of bowel obstruction from March 2008 to January 2010, which came from the First Hospital of Jilin University .The patients had previous abdominal surgery. Admission combined with history, signs, laboratory examinations, the patients had been diagnosed adhesive intestinal obstruction, and excluded tumors, internal hernia, intussusceptions, volvulus, mesenteric vascular disease, fecal and other causes of intestinal obstruction. After the 80 patients in using the ordinary tube decompression, repeated enema, anti-inflammatory, fast water and other non-surgical therapy, proved to be ineffective. We used ileus tube, in combination with other treatment, including the fast water, repeated constipation enema, antibiotics, correcting water, electrolyte and acid-base balance disorders, total parenteral nutrition and so on. We analyze effect of ileus tube; include abdominal pain, bloating relief, self-recovery exhaust time, the first 24-hour digestion drainage, X-abdominal plain film orthostatic changes in liquid-gas surface and so on. We discuss value of ileus tube in the treatment of adhesive intestinal obstruction. After we used the ileus tube, Cured 60 people, 75.00% cure rate; 12 cases improved, the improvement rate is 15.00%. 8 cases were ineffective, ineffective rate is 10.00%. Ileus tube compared with general tube, include (1) abdominal pain, bloating remission rate :after we used the ileus tube, 62 cases of abdominal pain and bloating relief(77.50%), but used the general tube, only 47 cases of abdominal pain and bloating relief(58.75%), comparison between the two, P<0.05. (2) Self-discharge time: after we used the ileus tube, 72 patients recovered independent exhaust, the time was 4.4±2.7d. But all the 80 patients who used the general tube did not recover self-discharge. (3) The first 24-hour drainage volume of digestive juice: after we used the ileus tube, the first 24-hour drainage volume of digestive juice was 1520±610ml, but the general tube was 540±80ml, comparison between the two, P<0.05. (4) X ray changes in orthostatic abdominal plain film: After using the general tube, 80 patients showed no improvement in abdominal plain film. After treatment using the ileus tube, abdominal plain film by monitoring the changes in 72 patients'abdominal plain film shows much smaller or even disappear fluid plane, disappeared in 7.9±6.6d. (5) Drainage of fluid properties: after we used the ileus tube, 60 patients stool samples leads to dark yellow liquid, with odor, yellow intestinal fluid extraction in 20 patients. When using the general tube leads to yellow intestinal fluid in 15 cases, 30 cases of green bile-like liquid extraction, and 35 leads a white juice. (6) The tube tip position in the intestinal lumen:Obstruction after tube placement by X-line location, the ileus tube in all patients were located in the small intestine, 60 patients through the obstruction site, near the site of obstruction in 12 patients, 1 patient was discharged through the anus. 10 patients after failed conservative treatment, later we used surgical treatment, confirmed the small bowel adhesions into Group Results. 80 patients diagnosed as 21 cases of early postoperative intestinal obstruction. The use of the general tube therapy is not effective, are used ileus tube, 18 cases were cured, the cure rate was 85.71%, improvement in 3 cases, the improvement rate was 14.29%, 0.00% invalid. Observed in patients after ileus tube through the abdominal distension, abdominal pain level, self-discharge time, the first 24-hour digestion drainage, X ray orthostatic abdominal plain film, drainage fluid nature of the tube tip position in the intestinal lumen that six areas, we can see that the ileus tube in the treatment of adhesive intestinal obstruction were better than the general tube (P <0.05). In the application of non-surgical treatment of intestinal obstruction, the ileus tube can be more effective for gastrointestinal decompression, reducing bowel dilation, significantly improved clinical symptoms, reduce the surgery rate. For simple adhesive postoperative intestinal obstruction, treatment of the ileus tube is significantly. Adhesive intestinal obstruction is a good indication of the ileus tube. The early postoperative inflammatory ileus, Treatment obvious application of the ileus tube, can significantly improve symptoms and signs to promote the rehabilitation of patients to achieve cure.