The Clinical Study Of Ileus Tube Was Used As A Stent In The Intestinal Plication To Treat Severe Adhesive Intestinal Obstruction

Objective：To evaluate the application of intestinal plication by ileustube in the prevention intestinal adhesions and prevent bowel obstructionrecurrence.Methods：The analysis was based on50cases of intestinal plication byileus tube， which were collected from August2009to November2011ofChina-Japan Union Hospital of Jilin University. According to whether to usethe decompression of the ileus tube before surgery，it divided into two groups：28cases with the decompression treatment before surgery, and anterogradearranged of the ileus tube in the small intestine in surgery,22cases withretrograde arranged of the ileus tube in surgery. We observe the clinicalefficacy according to the patient’s age, preoperative laboratory tests, operationtime，the time of postoperative exhaust, duration of hospitalization andcompare the differences between the anterograde arranged group and theretrograde arranged group.Results: All50cases of male21, female29, age9to82years with a meanage:46.93years old, including the average age of the anterograde arrangedgroup was41.46±15.36,and retrograde arranged group was53.86±15.18; thetime of the whole group of patients exhausting was3.42±1.48days, in whichthe anterograde arranged group was3.46±1.5days, the retrograde arrangedgroup was3.23±1.18days; average duration of hospitalization of the wholegroup was37.28±19.72days, in which the anterograde arranged group was35.82±8.61days, and the retrograde arranged group was40.23±21.34days; The average time of extubation was11.42±3.82days, in which the antegradearranged group was11.36±4.23days, and the retrograde arranged group was11.54±3.56days; The results of the two groups have statistical significantdifferences in age，operation time by t test, P <0.01.But in the sex, averageduration of hospitalization, the postoperative recovery time of intestinalfunction, ASA preoperative assessment, preoperative leukocyte count, thenumber of red blood cells, and hemoglobin， there were no significantdifferences by t test, p>0.05, the difference is meaningless, which can be seenthat the small intestine obstruction tube bracket arrangement was no significantdifferences between the anterograde and retrograde arrangement.10patientscaught surgical-related complications, in which anterograde arranged groupwas4cases, and the other was6cases, three cases with anastomotic leakage,six cases with wound infection and catheter mouth infection,1case withintussusception, the other patients were followed up4to27months, no case ofrecurrence of intestinal obstruction. Compared the10cases (study group) withthe other40cases (control group), there were statistically significances inpreoperative laboratory tests, the number of previous surgery, and whethercatching complications by T-test, P <0.05.Conclusion:1.Direct decompression by ileus tube in the proximal intestine,effectively reducing the pressure within the obstruction of the intestine, reduceswelling, improve the general condition，create the conditions for the surgery.2.The ileus tube for stent anterograde arranged can effectively preventthe recurrence of intestinal obstruction and to avoid cecal colostomy is thepreferred arrangement. 3. The ileus tube for stent retrograde arrangement applies to preventionacute and severe adhesive small bowel obstruction.