| Backgrounds:Intestinal obstruction is one of common digestive system diseases. Intestinal obstruction can result in a series harm of intestinal organization and physiological disorder in whole body. Along with the increase in abdominal surgery,adhesive bowel obstruction take up more and more percentage in intestinal obstruction.In recent years,the main reason of intestinal obstruction is the adhesion after surgical operation instead of the strangulated hernia.According to Ellis'statistics, adhesive small bowel obstruction accounted for 40 percent of the total number of intestinal obstruction,60 percent of small intestinal obstruction in 1999 in Englang. While, adhesive bowel obstruction occupy 60 percent of tatal in 2004 in the Unite State. Many surgeons are inclined to choose conservative treatment because surgery can increase the recurrence risk of adhesive bowel obstruction. The traditional conservative treatments of intestinal obstruction include gastrointestinal decompression, correction of water and electrolyte's supersession, maintenance of acid-base counterbalance,parenteral nutrition, antibiotic, traditional medicine and physical therapy. Gastrointestinal decompression is the most effective way to treat with acute bowel obstruction without any indications of strangulation mortality rate in the world. The traditional nasogastric tube is not long enough for suction of the distal intestine and the clinical efficacy is finite. In 2003, a silicon hydrophilic ileus tube with double balloons and three channels was successfully applied in Japan,which realized the whole small intestine'drainage and decompression. Thoroughly suction could be performed, and clinical symptoms could relieve rapidly.Moreover, the long tube progress down and itself can perform as a staddle for the arrangement of the bowel and reduce adhesion recurrence rate. Diagnostic radiographic enteroclysis studies are facilitated, which do the surgeons a favor before operations.According to different position,there are two types of ileus tube:transnasal ileus tube and transanus ileus tube.Ileus tube can been installed by means of endoscope and under radiophotography.In the beginning stage of application of ileus tube,the systematically clinical applied reports were rare in our country. Reports of the difference of clinical therapeutic efficacy between ileus tube and nasogastric tube treating with different patients were rare.Objective:207 cases of patients with acute intestinal obstruction were reviewed retrospectively,102 cases adopted an ileus tube advanced endoscopically for gastrointestinal decompression, the other 105 patients with ordinary nasogastric intubation for decompression were selected during the same period as the control group. To compare the clinical efficacy for different types of obstruction between the two decompression methods.Methods:207 cases of patients with acute intestinal obstruction from Jan 2007 through Aug 2010.102 patients adopted ileus Tube for gastrointestinal decompression, Another 105 patients in the control group used traditional nasogastric tubes for decompression. Each groups'clinical and radiological improvements and laboratory findings had been observed and analysed. Statistical analysis was performed with SPSS software version 16.0. Data were expressed as means±SE. Enumeration data was analyzed by Chi-square test, measurement data was analyzed by Student's t-test. P< 0.05 was considered statistically significant.Results:1) In ileus tube group,the time for relieving abdominal pain and distension and for improving bowel movement as well as abdominal radiograph were significantly shorter than that of the control group, P<0.01; The tube output on the first day was greatly larger than the control group, P<0.01; The proportion of patients that need surgery in ileus tube group was significantly lower than that of control group (31.4%VS64.8%), P <0.01; the total effective rate was greatly increased compared to the control group (88.2% VS 35.2%),P<0.01.2) Ileus tube was more effective compared to the nasogastric tube, either for non-malignant intestinal obstruction (including adhesive and adynamic) or for malignant intestinal obstruction (88.2% VS 35.2%),P<0.01.3) Ileus tube was more effective compared to the nasogastric tube,either for small intestinal obstruction or colorectal obstruction, P<0.01.4) In ileus tube group, the efficacy for non-malignant intestinal obstruction was higher than the malignant intestinal obstruction, P<0.01.5) In ileus tube group,the patients who underwent operation had longer time for recovering of bowel movement and abdominal radiographs compared to the patients without operation, P<0.01,respectively.Conclusions:Ileus tube can quickly and effectively relieve the patients'symptoms arising from acute intestinal obstruction, and reduce the risk of surgery. It showed an effect that superior to ordinary nasogastric tube for different types of bowel obstruction, especially for adhesive small bowel obstruction.During decompression, the observation of bowel motility and abdominal radiographs may present some cues for operation indications. |
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