关键词: 内窥镜检查, 胃肠道, 肠梗阻, 插管法, 胃肠, 减压

Abstract: Objective：To improve the diagnosticability of selective enteroclysis in the area of intestinal obstruction, by reviewing the cases of selective intestinal enteroclysis through a naso-intestinal decompression tube, and evaluating its diagnostic concordance level and the influence factors. Methods: The selective enteroclysis was different from traditional enteroclysis; it utilized a naso-intestinal decompression long tube to perform local intestinal opacification. In the four years between Apr. 2008 and Apr. 2012, 98 cases of selective intestinal enteroclysis were analyzed retrospectively, and diagnostic concordance value was made between the radiologic diagnosis and the final clinical diagnosis recorded in the medical history according to an evaluating criterion. Five scores were used in the evaluating system: 0 meant that the enteroclysis had no valuable information to provide; 0.25 meant that the enteroclysis could prompt the occurring of obstruction, but could not provide the information of location and cause; 0.50 meant that the enteroclysis could find the location of obstruction, but could not determine the cause; 0.75 meant that the enteroclysis could provide some valuable analysis of the causes of the obstruction, and very close to the final clinical diagnosis; 1.00 meant that the complete concordance between the enteroclysis diagnosis and the final clinical diagnosis. The influence factors would also be considered to improve the competence of the selective enteroclysis in the diagnosis of intestinal obstruction. Results: In the 98 cases, 53.1% had definite abdominal operative history. The most common cause of obstruction was conglutination between intestinal loops when discharged from hospital, almost occupying 50%. In this group of cases, the most common types were ileum obstruction (47.6%), multiple location obstruction (41.7%) and incomplete obstruction (59.5%). Conglutination and stricture of the intestinal was the common radiologic appearance (61.9%). There were 50 cases with higher concordance scoring 0.75 or 1.00, in comparison, there were 25 cases with lower concordance scoring 0 or 0.25. The difference between the two groups had statistical significance. Conclusion: As a combination of traditional enteroclysis and nasointestinal decompression tube, selective intestinal enteroclysis could exert higher diagnostic ability than that of traditional enteroclysis and also could break through the limitations of traditional enteroclysis in the condition of intestinal obstruction. This method has higher diagnostic concordance and could provide valuable information in obstruction location, extent, severity and possible causes. The main factor influencing the effectiveness of the examination is the location of the decompression tube and dynamic observation would be very helpful and important.

Key words: Endoscopy,gastrointestinal, Intestinal obstruction, Intubation,gastrointestinal, Decompression