目的

评价X线透视下使用导丝交换技术经鼻置入肠梗阻减压导管治疗术后早期小肠梗阻（EPSBO）的临床疗效。

方法

42例患者因EPSBO需行小肠减压治疗。肠梗阻减压导管在透视下经鼻置入，首先使用导引导丝通过幽门，然后使用10 F营养管作为交换置入超硬导丝，最后经超硬导丝置入肠梗阻减压导管于小肠。记录总的操作时间、透视时间和并发症情况。

结果

全部患者肠梗阻减压导管均顺利置入，技术成功率为100%。平均操作时间为（24.4±6.6）min，平均X射线曝光时间为（15.0±5.8）min。无严重并发症发生。36例患者（86%）经小肠梗阻导管减压后症状完全好转，无需行进一步手术治疗。

结论

透视下使用导丝交换技术经鼻置入肠梗阻减压导管技术成功率高，对EPSBO患者减压安全有效。

Objective

To investigate the wire-exchange technique to place a long tube into the small bowel under fluoroscopic guidance and to evaluate the decompression effect on early postoperative small bowel obstruction（EPSBO）.

Methods

Forty-two patients with EPSBO requiring decompression were enrolled in the study.Insertion of a long tube was guided by fluoroscopy.We first used the guide wire to pass the pylorus and then used the 10 F feeding tube as an exchangeable tube to put the superstiff wire.Finally the long tube could be passed over the guide wire through the pylorus into the intestine.The total procedure time，the radiation exposure time，and the rate of complications were evaluated.

Results

The long tubes passed into the jejunum on initial insertion for all patients，so the technique success rate was 100%.The mean total procedure time was（24.4±6.6）min，and the mean radiation exposure time（15.0±5.8）min.No major complications occurred.A total of 36 patients（86%）experienced full recovery following long-tube decompression and without the need for surgical intervention.

Conclusion

Using the wire-exchange technique is easily to place a long tube into the small bowel under fluoroscopic guidance and the decompression is safe and effective for management of EPSBO.