放射性肠瘘的诊断及外科治疗  

Diagnosis and treatment of radiation intestinal fistula.

作　　者：邵冰峰[1] 蒋松琪[1] 张素青[1] 朱汉达[1] 黄健[1] 陈铁[1] 

机构地区：[1]江苏省南通市肿瘤医院,226361

出　　处：《中国实用外科杂志》2005年第5期282-283,共2页Chinese Journal of Practical Surgery

摘　　要：目的探讨放射性肠瘘的诊断及外科治疗方法。方法回顾性分析南通市肿瘤医院1998年1月至2004年9月诊治的28例放射性肠瘘临床和病理资料。结果28例中,宫颈癌行放疗26例,直肠癌及膀胱癌术后行补充放疗各1例。肠瘘多发生于放疗后半年至2年内,肠瘘发生前均有不同程度放射性肠炎表现。直肠阴道瘘24例,其中复杂瘘2例,均作近端结肠造口转流粪便;回肠膀胱瘘2例,乙状结肠阴道瘘及小肠穿孔各1例,均作瘘口切除Ⅰ期肠吻合。结论放射性肠瘘发生与正常组织受量及个体差异等有关,放射性肠炎是肠瘘的早期症状。近端结肠造口转流粪便或瘘口切除肠吻合为其主要治疗方法。Objective To study the diagnosis and therapy for radiation intestinal fistula(RIF).Methods From 1998～2004,a total of 28 patients with RIF were retrospectively analyzed.Results The reviewed diagnosis were 26 cervical cancer after radiotherapy,1 rectal cancer and 1 bladder cancer every after operation.RIF often occurred in 0.5 to 2 years.Radiation enteritis occurred before intestinal fistula in different degree.The reviewed diagnosis were 24 cases of rectovaginal fistuias including 2 complex rectovaginal fistulas accepted colostomy frontward altering the fecal.2 ileovesical fistulas cases and 1 colon sigmoideumvainjuryand 1 perforation of intestine accepted resection of ileum fistulas and re-anastomosis of the ileum.Conclusions RIF is one of the long-term severe complications by radiation injury and related to the irradiation absorbed dose of normal tissues,individual difference and et al.Radiation enteritis is the early symptoms of RIF.Colostomy frontward altering the fecal or resection of ileum fistulas and re-anastomosis of the ileum are the main methods of treatment.

关 键 词：放射损伤 肠瘘 结肠造口术 手术治疗 

分 类 号：R656[医药卫生—外科学]