床旁盲插经鼻型肠梗阻导管联合续贯肠内营养治疗粘连性小肠梗阻的疗效

doi:10.3969/j.issn.1006-5725.2025.08.013

Abstract

Abstract:

Objective To investigate the efficacy of treating adhesive small intestinal obstruction using blind insertion of a nasal ileus catheter in combination with continuous enteral nutrition. Methods The data of patients with adhesive small intestinal obstruction admitted to our department from January 2022 to December 2023 were retrospectively collected. Group A was treated with blind insertion of a nasal jejunal decompression catheter， whereas Group B was managed with a nasogastric tube. Continuous enteral nutrition was initiated after the resolution of intestinal obstruction in both groups. The nutritional indices， abdominal improvement， inflammatory markers， and complication rates were compared between the two groups before and after treatment. Results In terms of nutritional indices， the scores for Alb， Pa， and NRS2002 in Group A were significantly higher than those in Group B on the 7th day （P < 0.05）. Regarding abdominal improvement indices， Group A demonstrated significantly better outcomes than Group B in daily average decompression drainage volume， daily average reduction in abdominal circumference， relief time for abdominal distension and pain， recovery time for exhaust， defecation， time to resumption of enteral nutrition， and total hospitalization duration （P < 0.05）. Concerning inflammatory indices， CRP， IL-6， and WBC levels in Group A were significantly lower than those in Group B on both the 4th and 7th days post-treatment （P < 0.05）. With regard to complications， Group A exhibited fewer cases of EN intolerance， reflux， and conversion due to conservative treatment ineffectiveness compared to Group B （P < 0.05）. Conversely， Group B had fewer instances of water and electrolyte imbalance compared to Group A （P < 0.05）. Conclusion Adhesive small intestinal obstruction treated with blind insertion of a nasal ileus catheter combined with continuous enteral nutrition is a safe and effective approach， making it worthy of promotion in clinical practice.

Key words: adhesive small bowel obstruction, blind insertion, intestinal obstruction catheter, enteral nutrition

CLC Number:

R459.3

Yang HE,Zhibing HOU,Lie WANG,Jingxiang SONG,Yu. WANG. The efficacy of adhesive small bowel obstruction treated with blind insertion of nasal intestinal obstruction catheter combined with continuous enteral nutrition[J]. The Journal of Practical Medicine, 2025, 41(8): 1175-1180.

Figures/Tables 6

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References 23

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项目	A组（n = 42）	B组（n = 37）	χ² /t/Z值	P值
性别（男/女）/例	22/20	17/20	0.326	0.568
年龄/岁	57.69 ± 6.72	59.05 ± 8.52	0.791	0.431
BMI/（kg/m²）	22.53 ± 1.83	22.46 ± 1.41	0.264	0.792
入院前梗阻时间/h	71.53 ± 9.77	74.31 ± 8.61	1.332	0.187
入院NRS 2002评分［M（P₂₅，P₇₅）］/分	4（3，4）	4（3，5）	0.466	0.641
入院白蛋白/（g/L）	38.17 ± 3.30	38.14 ± 4.67	0.035	0.972
入院前白蛋白/（g/L）	161.21 ± 29.98	169.65 ± 23.70	1.374	0.173
入院BUN/（mmol/L）	5.94 ± 2.24	6.54 ± 1.66	1.333	0.187
入院Hb/（g/L）	122.57 ± 12.51	121.38 ± 12.90	0.417	0.678
入院体温/℃	37.18 ± 0.62	37.03 ± 0.48	1.211	0.230
入院脉搏/（次/min）	87.17 ± 6.19	89.91 ± 7.08	1.838	0.070
入院CRP/（mg/L）	13.27 ± 3.56	11.78 ± 4.50	1.650	0.103
入院IL-6/（pg/mL）	186.12 ± 43.83	188.04 ± 46.69	0.189	0.851
入院WBC/（10⁹/L）	10.31 ± 2.43	10.68 ± 1.74	0.774	0.441
腹部手术史/例
阑尾手术史	9	7	0.077	0.782
小肠手术史	5	6	0.305	0.581
大肠手术史	12	8	0.503	0.478
妇科手术史	4	5	0.310	0.578
肝胆手术史	4	6	0.797	0.372
胰脾手术史	5	3	0.312	0.577
泌尿系手术史	3	2	0.100	0.752

项目	时间	A组（n = 31）	B组（n = 29）	t/Z值	P值
Alb/（g/L）	第1天	38.17 ± 3.30	38.14 ± 4.67	0.035	0.972
	第7天	40.69 ± 3.04	39.38 ± 1.93	2.253	0.027
Pa/（mg/L）	第1天	161.21 ± 29.98	169.65 ± 23.70	1.374	0.173
	第7天	245.31 ± 26.29	227.30 ± 30.84	2.802	0.006
BUN/（mmol/L）	第1天	5.94 ± 2.24	6.54 ± 1.66	1.333	0.187
	第7天	5.80 ± 1.67	6.05 ± 1.74	0.646	0.519
Hb/（g/L）	第1天	122.57 ± 12.51	121.38 ± 12.90	0.417	0.678
	第7天	121.86 ± 11.21	120.30 ± 10.33	0.640	0.524
NRS2002评分［M（P₂₅，P₇₅）］/分	第1天	4（3，4）	4（3，5）	0.532	0.596
	第7天	3（3，3）	3（3，4）	1.973	0.049

项目	A组（n = 42）	B组（n = 37）	t/Z 值	P值
日均减压引流量/mL	940.23 ± 204.06	536.44 ± 159.14	9.710	< 0.001
日均腹围减少量/cm	12.21 ± 2.88	5.79 ± 1.11	13.345	< 0.001
腹胀腹痛缓解时间/h	25.63 ± 2.18	70.54±11.78	22.845	< 0.001
恢复排气时间/h	71.40 ± 8.03	103.68 ± 11.52	14.265	< 0.001
恢复排便时间/h	91.77 ± 12.40	117.39 ± 13.92	8.656	< 0.001
恢复EN时间/h	79.05 ± 5.08	110.23 ± 8.20	20.577	< 0.001
总住院时间［M（P₂₅，P₇₅）］/d	9（8，10）	10（9，10）	3.180	0.001

项目	时间	A组（n = 31）	B组（n = 29）	t值	P值
CRP/（mg/L）	第1天	13.27 ± 3.56	11.78 ± 4.50	1.650	0.103
	第4天	8.24 ± 1.69	9.18 ± 1.11	2.893	0.005
	第7天	6.25 ± 1.42	7.08 ± 2.02	2.139	0.036
IL-6/（pg/mL）	第1天	186.12 ± 43.83	188.04 ± 46.69	0.189	0.851
	第4天	148.21 ± 22.52	160.21 ± 28.17	2.102	0.039
	第7天	98.14 ± 14.09	126.93 ± 16.58	8.345	< 0.001
WBC/（10⁹/L）	第1天	10.31 ± 2.43	10.68 ± 1.74	0.774	0.441
	第4天	7.21 ± 1.43	8.48 ± 1.54	3.803	< 0.001
	第7天	6.55 ± 1.05	7.19 ± 1.33	2.382	0.020

项目	A组（n = 42)	B组（n = 37）	χ² 值	P值
EN不耐受	5	12	4.908	0.027
反流	4	11	5.221	0.022
咽部不适	38	35	0.475	0.491
导管脱出/堵管	4	3	0.049	0.825
水电解质紊乱	27	15	4.454	0.035
HAP/VAP	1	1	0.008	0.928
保守无效中转手术	2	8	5.057	0.025

The efficacy of adhesive small bowel obstruction treated with blind insertion of nasal intestinal obstruction catheter combined with continuous enteral nutrition

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