医源性肠外瘘的分型和CT表现  

Classification and CT Appearances of Iatrogenic Enterocutaneous Fistulae

作　　者：黄伟[1] 卢光明[1] 苏宏[1] 王修来[1] 李峰[1] 袁立友[1] 梁泉[1] 

机构地区：[1]南京军区南京总医院医学影像科,南京210002

出　　处：《放射学实践》2007年第3期256-258,共3页Radiologic Practice

基　　金：江苏省"六大人才高峰"项目资助(2005A2)

摘　　要：目的:探讨医源性肠外瘘的分型和CT表现。方法:对754例医源性肠外瘘实施了CT检查。参照临床分型,将肠外瘘分为管状瘘、唇状瘘和断端瘘三个类型,并分析其CT征象。结果:管状瘘所占比例最高(占68.70%),表现为内、外口之间不均匀的管道形成;唇状瘘(占31.30%)的CT征象特点是较大的外口,呈唇状改变,无瘘管形成。管状瘘的腹腔和腹膜后脓肿发生率明显高于唇状瘘(P<0.01),而唇状瘘的肠壁炎性改变发生率较高(P<0.01)。结论:CT检查能够显示医源性肠外瘘的临床分型,对治疗具有指导性作用。Objective：To discuss the classification of iatrogenic enterocutaneous fistulae and their relative CT appearances. Metbods：Computed tomog aphy （CT） was performed in 754 patients with iatrogenic enterocutaneous fistulae. Clinically,enterocutaneous fistulae were classified as three types：ductal fistulae,labral fistulae and disconnecting fistulae. Their relative CT appearances were retrospectively reviewed. Results：The incidence rate of the ductal fistulae was the highest,accounting for 68.70% of the cases. There was an irregular channel communicating the internal opening and its external counterpart in a ductal fistula. The characteristic sign of the labral fistula,accounting for 31.30% of the cases,was the one without a ＂fistula＂, however, with a considerably large external opening and its labrum-like rims. The occurrence rate of intra-abdominal and retroperitoneal abscesses was significantly higher in the cases of ductal fistulae than that in lahral fistulae （P〈 0.01） ,while the inflammatory involvements of the intestinal walls were more frequently seen in the cases with labral fistulae than those with ductal fistulae （P〈0.01）. Conclusion：CT features were able to demonstrate and help the clinical classification of iatrogenic enterocutaneous fisrulae and further assist the selection of appropriate clinical treatments as well.

关 键 词：体层摄影术 X线计算机 医源性 肠瘘 

分 类 号：R656.9[医药卫生—外科学] R816.5[医药卫生—临床医学]