Analysis Of The Reasons For Failure In Treatment Of Acute Intestinal Obstruction By Ileus Tube

Objective: To evaluate the reasons for failure in treatment of acuteintestinal obstruction by ileus tube.Methods: The study was based on acute intestinal obstruction,which were collected from August2007to August2012inGastrointestinal surgery of China-Japan Union Hospital of JilinUniversity. Forty-eight of all cases underwent poor effect after usingileus tube and accepted surgery. The clinical data of the previousoperation history, clinical effect and intraoperative findings wereanalyzed retrospectively.Result: Among the48cases，22male and26female，the averageage was48.2±19.0.Forty cases had previous abdominal surgery (83%)，including25cases by one-time surgery（52%），15cases by several times（31.25%）.According to surgical site，above cases divided into twogroup：upper abdominal surgery in19cases（47.5%），the rate ofmalignancy was10/19（52.6%）；lower abdominal surgery in21cases，the rate of malignancy was18/21（85.7%）.The rate of malignant surgeryin lower abdominal is higher than others，the result has significantstatistical differences by Chi-square-test(P<0.05).According to treatmenttime of ileus tube it is divided into two group compare clinical effect:from tube insertion to the third day and the fourth day to the seventh day.The entered length of ileus tube and the contents of gastrointestinal decompression were70.83±52.76cm，1260.68±750.55ml respectively inthe former，and35.35±26.64cm，756.82±453.96ml in the latter whichwas poorer in clinical effect.Under the treatment of T-test, there wassignificant difference （P<0.05）.The rate of non-improvement ofabdominal pain and distension was11/48（22.9%）in first group（fromtube insertion to the third day），and24/43（55.8%）in second group（from the fourth day to the seventh day），the result has significantstatistical differences by Chi-square-test(P<0.05).But no statisticaldifference in white blood cell count，neutrophil ratio，X-ray or CT（P<0.05）.Forty-eight of all cases，which were underwent a surgery forfailure by ileus tube，were divided into adhesion and non-adhesion bysurgical findings.Among the patients who had previous abdominaloperation history，adhesion accounts for38/40（95%）: Angulation ofintestinal adhesion21/38（55.3%），Conglobation of intestinal adhesion17/38（44.7%）.Among the patients whitout previous abdominal operationhistory，non-adhesion accounts for8/8（100%）: Intestinal TumorObstruction6/8（75%），Paralytic Intestinal Obstruction2/8（25%）.Theresult shows significant difference between two groups（P<0.01）.Conclusion：1.Angulation and conglobation of previous abdominal operativeintestinal adhesion are the most common causes of failure byileus tube. 2.Intestinal Tumor Obstruction is one of the common causes offailure by ileus tube， among the patients without previousabdominal operation.3.There’s a higher risk of failure in treatment of the intestinalobstruction by ileus tube after lower abdominal malignantsurgery...