[1]方世明,李海利,林　　　青,等. Ｘ线引导下鼻肠梗阻导管插入引流治疗不能手术的恶性肠梗阻[J].介入放射学杂志,2011,(12):979-983.
　FANG Shi-ming,LI Hai-li,LIN Qing,et al.Fluoroscopically-guided transnasal insertion of ileus tube for intestinal decompression in patients with inoperable malignant bowel obstruction[J].journal interventional radiology,2011,(12):979-983.
点击复制

 Ｘ线引导下鼻肠梗阻导管插入引流治疗不能手术的恶性肠梗阻 ()

PDF下载中关闭

分享到：

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2011年12期
页码:
979-983
栏目:
非血管介入
出版日期:
2011-12-30

文章信息/Info

Title:
Fluoroscopically-guided transnasal insertion of ileus tube for intestinal decompression in patients with inoperable malignant bowel obstruction
作者:
 方世明; 　　　李海利; 　　　林　　　青; 　　　茅爱武; 　　　吴邵秋; 　　　姜昊声; 　　　曹　　　燕; 　　　王震磊
200050 上海 上海长宁区同仁医院介入诊疗中心；内蒙古医学院第三附属医院
Author(s):
FANG Shi-ming;  LI Hai-li;  LIN Qing;  MAO Ai-wu;  WU Shao-qiu;  JIANG Hao-sheng;  CAO Yan;  WANG Zhen-lei.
Interventional Therapeutic Center, Shanghai St. Luke＇s Hospital, Shanghai 200050, China

关键词:
 ; 【关键词】 恶性肿瘤;  肠梗阻;  鼻肠管;  引流
分类号:
R735
文献标志码:
A
摘要:
 【摘要】 目的 评价Ｘ线引导下经鼻插入鼻肠梗阻导管治疗不能手术的恶性肠梗阻的技术可行性和疗效。方法 Ｘ线引导下应用传统法（７６例）或导丝导管交换法（１３５例）经鼻插入鼻肠梗阻导管引流治疗不能手术的恶性肠梗阻患者２１１例（ＫＰＳ ２０　～　６０分，中位４０分），统计技术成功率、临床有效率、治愈率和不良反应及并发症发生情况；分析梗阻部位、梗阻原因与疗效关系。鼻肠梗阻导管采用库利艾特公司生产的四腔双球囊导管，管径为１６ Ｆ／１８ Ｆ。结果　　　总技术成功率１００％，传统法和导丝导管交换法一次性成功率分别为８５．５％（６５／７６）和１００％（１３５／１３５），两种方法比较差异有统计学意义（Ｐ　＜　０．０５）。术后２４ ｈ，高位小肠、低位小肠和结直肠梗阻的临床有效率分别为９５．８％（４６／４８），９２．９％（１１７／１２６）和８３．８％（３１／３７）。随访４　～　２４５ ｄ（平均１３８ ｄ），总临床治愈率２７．５％（５８／２１１），肿瘤性与粘连性梗阻的临床治愈率分别为２２．７％（４２／１９４）和９４．１％（１６／１７），两者间差异有统计学意义（Ｐ　＜　０．０５）。小肠和结直肠恶性梗阻的临床治愈率分别为１２．７％（２０／１５７）和５９．５％（２２／３７），两者间差异有统计学意义（Ｐ　＜　０．０５）。不良反应及并发症包括咽部不适或疼痛９９．１％（１９９／２１１）、导管阻塞２３．２％（４９／２１１）、导管脱落１．９％（４／２１１）、 导管断裂０．１％（２／２１１）、肠出血０．１％（２／２１１）、肠穿孔０．１％（１／２１１），总的严重并发症发生率为４．７％，涉及咽部剧痛、肠出血、肠穿孔、导管断裂；无与死亡相关的并发症。结论　Ｘ引导下经鼻肠梗阻导管插入引流治疗不能手术的恶性肠梗阻安全、有效，尤其适用于术后粘连性小肠梗阻以及结肠直肠恶性狭窄支架置入前的评估和治疗。

参考文献/References:

[1] 梁国刚, 毕 伟, 张盛林, 等. 肠梗阻导管治疗肠梗阻-附36例报告[J]. 中国中西医结合外科杂志, 2006, 12: 191 - 193.
[2] 邵海波, 苏洪英, 徐 克, 等. DSA引导下经鼻肠梗阻减压导管置入术治疗粘连性小肠梗阻[J]. 中国医学影像技术, 2009, 25: 2114 - 2117.
[3] Kanno Y, Hirasawa D, Fujita N, et al. Long intestinal tube insertion with the ropeway method facilitated by a guidewire placed by transnasal ultrathin endoscopy for bowel obstruction[J]. Dig Endosc, 2009, 21: 196 - 200.
[4] Anthony T, Baron T, Mercadante S, et al. Report of the clinical protocol committee: development of randomized trials for malignant bowel obstruction[J]. J Pain Symptom Manage, 2007, 34: S49 - S59.
[5] Kim H, Kim SH, Choi SY, et al. Fluoroscopically guided placement of self-expandable metallic stents and stent-grafts in the treatment of acute malignant colorectal obstruction[J]. J Vasc Interv Radiol, 2008, 19: 1709 - 1716.
[6] Baron TH. Colonic stenting: technique, technology, and outcomes for malignant and benign disease[J]. Gastrointest Endosc Clin N Am, 2005, 15: 757 - 771.
[7] Sato R, Watari J, Tanabe H, et al. Transnasal ultrathin endoscopy for placement of a long intestinal tube in patients with intestinal obstruction[J]. Gastrointest Endosc, 2008, 67: 953 - 957.
[8] Kanno Y, Hirasawa D, Fujita N. Long-tube insertion with the ropeway method facilitated by a guidewire placed by transnasal ultrathin endoscopy for bowel obstruction: a prospective, randomized,controlled trial[J]. Gastrointest Endosc, 2009, 69: 1363 - 1368.



 

相似文献/References:

[1].Spontaneous regression of a giant basilar artery aneurysm in a young adult after surgical injury ：case report and literature review[J].介入放射学杂志,2007,(10):718.
　ZHANG He,LI Ming-hua,WANG Chun,et al.Spontaneous regression of a giant basilar artery aneurysm in a young adult after surgical injury ：case report and literature review[J].journal interventional radiology,2007,(12):718.
[2]李统怀,郑红枫. 子宫动脉栓塞治疗子宫瘢痕妊娠１１例[J].介入放射学杂志,2011,(11):898.
　LI Tong-huai,ZHENG Hong-feng..Clinical application of uterine artery embolization in treating uterine scar pregnancy[J].journal interventional radiology,2011,(12):898.
[3]吕维富,张爱武,周春泽,等. 子宫动脉的三维DSA表现及其最佳显示体位探讨[J].介入放射学杂志,2011,(11):853.
　LV Wei-fu,ZHANG Ai-wu,ZHOU Chun-ze,et al.3D-DSA findings of uterine artery and its optimal projection position[J].journal interventional radiology,2011,(12):853.
[4]张 靖,周少毅,陈昆山,等.经导管动脉硬化栓塞联合注射硬化治疗婴儿颌面部巨大高流量血管瘤[J].介入放射学杂志,2011,(11):848.
　ZHANG Jing,ZHOU Shao-yi,CHEN Kun-shan,et al.Transcatheter arterial sclerosing embolization with injection sclerotherapy for the treatment of huge and high-flow maxillofacial hemangiomas in infants[J].journal interventional radiology,2011,(12):848.
[5]谢小西,吕银祥,章宏欣,等. 肝动脉化疗栓塞、射频消融联合１２５Ⅰ粒子植入 治疗原发性肝癌的临床应用[J].介入放射学杂志,2011,(11):863.
　XIE Xiao-xi,LV Yin-xiang,ZHANG Hong-xin,et al.The clinical application of TACE together with RFA and 125Ⅰ seed implantation in treating hepatocellular carcinoma[J].journal interventional radiology,2011,(12):863.
[6]王铭义,王 峰. 脑灌注成像在颈动脉狭窄介入治疗中的应用[J].介入放射学杂志,2011,(11):915.
　WANG Ming-yi,WANG Feng..Application of brain perfusion imaging in interventional treatment of carotid artery stenosis[J].journal interventional radiology,2011,(12):915.
[7]杜 猛,张锦生. 介入治疗急性深静脉血栓的临床观察[J].介入放射学杂志,2011,(11):858.
　DU Meng,ZHANG Jing-sheng..Interventional therapy for acute deep venous thrombosis: a clinical observation[J].journal interventional radiology,2011,(12):858.
[8]孟庆娜,李国庆,白晓冬. 急性心肌梗死介入治疗术中恶心呕吐的护理[J].介入放射学杂志,2011,(11):913.
　MENG Qing-na,LI Guo-qing,BAI Xiao-dong..The nursing care of nausea and vomiting occurred in interventional treatment for acute myocardial infarction[J].journal interventional radiology,2011,(12):913.
[9]王海亭,蒋忠仆,周 毅,等. 透视引导下鱼肝油酸钠泡沫硬化剂治疗下肢静脉曲张３０例[J].介入放射学杂志,2011,(11):905.
　WANG Hai-ting,JIANG Zhong-pu,ZHOU Yi,et al.Fluoroscopically-guided foam sclerotherapy with sodium morrhuate for the treatment of lower extremity varices[J].journal interventional radiology,2011,(12):905.
[10]杜 鲲,管 生,胡小波,等. 原发性肝癌ＴＡＣＥ术后完全缓解病灶磁共振 ＡＤＣ值可重复性及一致性研究[J].介入放射学杂志,2011,(11):867.
　DU Kun,GUAN Sheng,HU Xiao-bo,et al.Magnetic resonance apparent diffusion coefficient values of the completely remitted lesions of primary hepatocellular carcinoma after TACE: a study of their repeatability and consistency[J].journal interventional radiology,2011,(12):867.
[11]邓美香,金泳海,倪才方,等.植入支架治疗恶性肿瘤压迫致髂静脉狭窄14例[J].介入放射学杂志,2014,(02):118.
　DENG Mei? xiang,JIN Yong? hai,NI Cai? fang,et al. Stent implantation for iliac vein stenosis caused by malignant tumor compression： analysis of 14 cases [J].journal interventional radiology,2014,(12):118.

备注/Memo

备注/Memo:
(收稿日期:2011-03-13)
更新日期/Last Update: