生长抑素、生长激素、营养支持在小肠外瘘早期确定性手术治疗中的应用  

The clinical use of somatostatin,somatotropin and nutritional support in early definitive surgery for enterocutaneous fistulas

作　　者：杨道贵[1] 邵峰[1] 李蕊[1] 李洪光[1] 隋永领[1] 

机构地区：[1]聊城市人民医院普通外科,山东聊城252000

出　　处：《肠外与肠内营养》2004年第4期199-201,共3页Parenteral & Enteral Nutrition

摘　　要：目的 :探讨生长抑素、生长激素、营养支持在小肠外瘘早期确定性手术治疗中的效果。　方法 :本组共 2 2例 ,均为小肠肠外瘘 ,早期确定性手术距瘘诊断间隔时间为 6～ 97h ,其中 1 5例在瘘发生后 4 8h内手术。 2 1例行小肠部分切除吻合术 ,1例行肠瘘楔形切除修补术 ;术后给予生长抑素 +重组人生长激素 +营养支持。术后 3天内给予生长抑素 ,3天后给予重组人生长激素 ,共 5～ 7天。　结果 :2 2例病人均获成功 ,术后未再发生肠瘘。胃肠功能恢复时间平均为 (9.6± 5 .9)天 ;完全恢复经口进食时间平均为 (1 3.1± 6 .2 )天。　结论 :对小肠外瘘病人进行早期确定性手术后 ,采用生长抑素 +重组人生长激素 +营养支持方案 ,能确保肠吻合口的愈合 ,提高肠外瘘的治愈率 。Objectives: The effect of somatostatin,somatotropin and early definitive surgery for enterocutaneous fistulas was determined. Methods: 22 patients with small intestinal external fistulas consisted of 13 males and 9 females. 20 patients had one fistula and 2 patients had two or more fistulas.The causes of the fistula included abdominal injury(10),gynecological procedures(3),appentectomy(5)and other intestinal procedures(4).The time between definitive surgery and previous operation or trauma was 6～97 hours and 15 patients was 48 hours or shorter. 21 patients was resection of enterocutaneous fistulas and anastomosis by hand absorble suture,and enterocutaneous fistula was repaired simply in one patient. The combination of somatostatin, somatotropin and nutrition support was given in all patients postoperatively. Results: All patients were cured and no enterocutaneous fistulas was observed.The gastrointestinal function restored after(9.6±5.9)days and oral feeding restored(13.1±6.2)days after reoperation. Conclusions: With somatostatin,somatotropin and nutrition support,early definitive surgery can be performed safely and effectively for enterocutaneous fistulas of small intestine even with severe intra abdominal sepsis.

关 键 词：生长抑素 生长激素 营养支持 小肠外瘘 手术治疗 生长抑素 

分 类 号：R656.7[医药卫生—外科学]