术后肠外瘘的诊治体会  

The discussion on the diagnosis and treatments of enterocutaneous fistula after abdominal surgeries

作　　者：刘红权[1] 谢元才[1] 周林[1] 赖承治[1] 

机构地区：[1]赣州市人民医院普外科,江西赣州341000

出　　处：《赣南医学院学报》2011年第2期248-249,共2页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：目的:探讨腹部手术后肠外瘘的病因、诊断及治疗方法。方法:回顾性分析20例肠外瘘的发生原因及诊治情况。结果:十二指肠残端瘘3例,小肠瘘6例,阑尾残端瘘2例,结肠瘘3例,直肠瘘5例,胃溃疡穿孔修补处瘘1例。主要原因有:①感染性吻合6例;②病理组织上吻合5例;③操作技术偏差4例;④炎性肠病、引流管压迫等5例。全组治愈17例,2例未愈等待手术,1例自动出院。结论:肠外瘘原因是多方面的,在维持内稳态和营养支持的前提下,建立有效的引流,应用生长抑素、生长激素,多数能自愈。Obsjective：To investigate the etiology,diagnosis,and treatments of enterocutaneous fistula after abdominal surgeries.Methods：Retrospectively analyzed the causes and treatments of 20 enterocutaneous fistula cases from October,2008 to August,2010.Results：3 cases of duodenal stump fistula,6 cases of intestinal fistula,2 cases of appendiceal stump fistula,3 cases of colon fistula,5 cases of rectal fistula,and 1 case of gastric fistula after gastric ulcer perforation repair.Main reasons： ① 6 cases of infectious anastomosis;② 5 case of pathological anastomosis;③ 4 cases of technique deviation;④ 5 cases of inflammatory bowel disease and oppression of drainage tubes.17 cases were cured,2 cases are waiting for surgeries,1 patient was discharged with no treatment.Conclusion：There are many reasons causing enterocutaneous fistula.With an effective drainage and applicatioin of somatostatin and growth hormone,most cases can be self-healing.

关 键 词：肠外瘘 诊断 治疗 

分 类 号：R656[医药卫生—外科学]