Li Dechun, Du Hongtao, Shao Guoqing, Guo Yongtuan, Lu Wan, Li Ruihong
Department of Radiology, Xuzhou Affiliated Hospital of Southeast University, Xuzhou, Jiangsu 221009, P.R. China.
Department of Nutriology, Xuzhou Central Hospital, Xuzhou, Jiangsu 221009, P.R. China.
Oncol Lett. 2017 Jul;14(1):180-184. doi: 10.3892/ol.2017.6153. Epub 2017 May 11.
The application value of small intestine decompression combined with oral feeding in the middle and late period of malignant small bowel obstruction was examined. A total of 22 patients with advanced malignant small bowel obstruction were included in the present study. An ileus tube was inserted via the nose under fluoroscopy into the obstructed small intestine of each patient. At the same time, the insertion depth the of the catheter was adjusted. When the catheter was blocked, small bowel selective angiography was performed to determine the location and cause of the obstruction and the extent of the obstruction, and to determine the length of the small intestine in the site of obstruction, and to select the variety and tolerance of enteral nutrition. We observed the decompression tube flow and ease of intestinal obstruction. In total, 20 patients were treated with oral enteral nutrition after abdominal distension, and 22 cases were treated by the nose to observe the drainage and the relief of intestinal obstruction. The distal end of the catheter was placed in a predetermined position. The symptoms of intestinal obstruction were relieved 1-4 days after decompression. The 22 patients with selective angiography of the small intestine showed positive X-ray signs: 18 patients with oral enteral nutrition therapy had improved the nutritional situation 2 weeks later. In 12 cases, where there was anal defecation exhaust, 2 had transient removal of intestinal obstruction catheter. In conclusion, this comprehensive treatment based on small intestine decompression combined with enteral nutrition is expected to become a new therapeutic approach and method for the treatment of patients with advanced tumor small bowel obstruction.
探讨小肠减压联合口服喂养在恶性小肠梗阻中晚期的应用价值。本研究共纳入22例晚期恶性小肠梗阻患者。在透视引导下经鼻为每位患者插入肠梗阻导管至梗阻小肠内，同时调整导管插入深度。当导管堵塞时，行小肠选择性血管造影以确定梗阻部位、原因及梗阻范围，确定梗阻部位小肠长度，选择肠内营养种类及耐受性。观察减压管引流量及肠梗阻缓解情况。腹胀后共有20例患者接受口服肠内营养治疗，22例经鼻治疗观察引流及肠梗阻缓解情况。将导管末端置于预定位置。减压后1 - 4天肠梗阻症状缓解。22例行小肠选择性血管造影患者X线表现阳性：18例行口服肠内营养治疗患者2周后营养状况改善。12例有肛门排便排气者中，2例肠梗阻导管短暂拔除。综上所述，这种基于小肠减压联合肠内营养的综合治疗有望成为晚期肿瘤性小肠梗阻患者治疗的新途径和方法。
