A Deeper Insertion Technique Of Ileus Tube For Patients With Acute Bowel Obstruction

BackgroundIleus tube has become an important method of conservative therapy of acute small bowel obstruction and a number of studies have confirmed its positive effect on acute intestinal obstruction.However,due to such deficiencies of ilues tube intubation as high friction between tubes and guide wires,shifting position constantly and the resistance of intestinal fold,it is difficult for the tube to get fully close to the obstruction site merely intubating the tube to duodenum or the ligament of Treitz.In view of the difficulties encountered in the process of ilues tube intubation,we have improved the traditional intubation method,named Deeper Intubation Technique,by using the Zebra Urological Guide wire,Digital gastrointestinal fluoroscopy and the catheter intubation is greatly deepened.PurposeThis study aims to find out the distinguishing treatment effects imposed by Deeper Intubation Technique(DT)and Traditional Intubation Technique(TT).Research methodsThis study compared the distinctive effects of acute intestinal obstruction with different intubation methods by reviewing a total of 183 patients who were diagnosed with acute intestinal obstruction by imaging and treated by ileus tube for decompression.95 cases adopted Deeper Intubation Technique(DT)and another 88 patients in control group adopted Traditional Intubation Technique(TT).Results1.The average intubation depth of DT obviously exceeds TT.(P<0.01).2.24 hours after the operation,the volume of drainage of DT was saliently more than TT,P<0.01.The patients treated by DT got lower pain score than the patients treated by TT,24 and 48 hours after intubation,and besides,the abdominal pain relieve rate were better than the group of TT,P<0.01.The recovery time for anal exhaust defecation and the relieve time of abdominal X-ray plain films of DT group were shorter than the TT group,P<0.05.The patients in DT group achieved a higher recovery rate in anal exhaust defecation and abdominal X-ray plain films than those in TT group,P<0.05.There was no statistic significance in both groups regarding to the patients who need surgery treatment and overall recovery rate,P>0.05.However,the emergency surgery rate in DT group was lower than TT group,P<0.05.3.For the patients with adhesions obstruction,the effects of DT were better than those in the TT group,P<0.05.For cancerous and stercoral obstruction,there was no statistic significance in both methods,p>0.05.ConclusionCompared with Traditional Technique,adopting Deeper Intubation Technique can enable the tube to come closer to the obstruction site,minimizes the bowel compression near the obstruction site,alleviates patients' symptoms more effectively and more quickly and reduce the emergency surgery rate,especially for adhesive intestinal obstruction.There are no differences between two methods for cancerous and stercoral obstruction.