早期手术治疗肠瘘的临床研究  

Early surgery in the management of enterocutaneous fistulas

作　　者：郭宏荣[1] 李峰[1] 穆春来[1] 杨昌平[1] 李文慧[1] 许中华[1] 

机构地区：[1]解放军第322医院普通外科,山西大同037006

出　　处：《中国现代医学杂志》2008年第14期2078-2080,共3页China Journal of Modern Medicine

摘　　要：目的研究在现代医疗条件下早期手术治疗肠瘘的临床效果。方法对采用早期手术治疗的25例肠瘘患者临床资料进行分析。本组患者男16例,女9例。其中十二指肠瘘3个,小肠瘘及小肠吻合口瘘18个,回结肠吻合口瘘1个,结肠瘘3个。有3例为多发瘘。小肠部分切除吻合术18例次,结肠部分切除吻合术3例次,回结肠吻合口切除再吻合术1例,瘘口单纯修补3例。结果本组患者全部治愈,无1例术后再发肠瘘。早期手术距发现瘘的时间为(5±2.5)d。住院时间为(21±7.2)d。结论在全静脉营养、ICU、生长激素和抑素的使用等现代医疗技术的支持下,根据具体情况采用恰当的手术方式,对于肠瘘进行早期手术治疗是可行的,并且提高了肠瘘的治愈率,缩短了病程。[Objective] To study the effective early surgery in enterocutaneous fistulas patients on modem medical condition. [Methods] 25 case of enterocutaneous fistulas with early surgery were reviewed. Enterocutaneous fistulas included 3 from duodenum, 18 from the small bowel, 1 from the ileocolic anastomotic dehiscence, and 3 from the colon. Among them 2 had multiple orifices fistulas. The resection of enterocutaneous fistulas with anatomosis was performed in 21 patients and simple repaired in 3 patients. The resection of the ileocolic anastomotlc fistulas with anastomosis was performed in 1.[Results] All patients were cured and no new enterocutaneous fistulas was observed. The time between early surgery and fistulas diagnosised was （5.0±2.5） days. The time in hospital was （21.0±7.2） days. [Conclusion] With appropriate surgical techniques, ICU, nutrition support, organ function support and somatostaln, somatotropin use, early surgery can be performed safely and effectively for enterocutaneous fistula patients.

关 键 词：肠瘘 生长抑素 生长激素 

分 类 号：R574[医药卫生—消化系统]