关键词: 粘连性肠梗阻；数字减影血管造影技术；经侧孔快速交换法；传统鼻胃管减压；疗效

Abstract: Objective Exploring the efficacy analysis of digital subtraction angiography (DSA) guided rapid exchange through lateral foramen and traditional nasogastric tube decompression in the treatment of adhesive intestinal obstruction.Methods A total of 84 patients with adhesive ileus admitted to our hospital from January 2019 to January 2021 were prospectatively selected as the study objects,and the patients were divided into the study group (42 cases) and the control group (42 cases) according to the random number table method.The control group was treated with traditional nasogastric tube decompression,and the study group was treated with DSA-guided tube decompression via lateral foraminal rapid exchange.Compare the differences in efficacy,recovery indicators (exhaust time,extubation time,eating time,first defecation time,abdominal pain relief time,X gas liquid level disappearance time,average hospitalization time),pain degree (VAS score),and quality of life (SF-36 score) between the two groups.Results Rank-sum test of hierarchical data showed that the difference in clinical efficacy between the two groups was statistically significant(P<0.05), and the total effective rate of the study group (92.86%) was higher than that of the control group (71.43%), which was statistically significant (P<0.05). In the study group, the time of exhaustion, extubation time, feeding time, first defecation time, abdominal pain relief time, X-ray gas-liquid plane disappearance time, and mean hospitalization time were (78.61±20.38) hours, (80.35±20.26) hours, (82.49±21.59) hours, (88.66±23.55) hours, (3.49±0.75) days, (4.31±1.16) days, and (6.53±1.10) days in the study group, respectively. The control group was (101.36±31.56) hours, (104.33±28.85) hours, (108.41±25.55) hours, (141.32±35.49) hours, (6.05±1.29) days, (7.29±1.32) days and (10.01±2.06) days, respectively. The difference between the two groups was statistically significant(P<0.05).Repeated-measures ANOVA Results showed that the VAS scores of the two groups were significantly lower at 1 day after treatment and 3 days after treatment compared with the pre-treatment period, and the VAS scores at 3 days after treatment were lower than those at 1 day after treatment, but the VAS scores of the study group were lower than those of the control group at 1 day after treatment and 3 days after treatment, and the difference was statistically significant(P<0.05). The scores of each factor of SF-36 scale at the time of discharge were higher in both groups compared with the pre-treatment period, and the scores of each factor of SF-36 scale at the time of discharge were higher in the study group than in the control group, and the difference was statistically significant (P<0.05).Conclusion DSA guided rapid exchange catheter decompression through lateral foramen has a good therapeutic effect on adhesive intestinal obstruction,which can effectively alleviate patient pain,promote early recovery,and improve quality of life.

Key words: adhesive intestinal obstruction; digital subtraction angiography technology; rapid exchange method through lateral pores; traditional nasogastric tube decompression; curative effect