直肠癌保肛术后肠外瘘的非手术治疗  

Non-operative Treatment of Anastomotic Leakage after Sphinctor Saving Resection of Rectal Cancer

作　　者：潘贻飞[1] 张筱骅[1] 叶国华[1] 林包荣[1] 陈雪敏[1] 李加枝[1] 

机构地区：[1]温州医学院附属第一医院肿瘤外科,浙江省温州市325000

出　　处：《中国肿瘤临床》2000年第8期607-610,共4页Chinese Journal of Clinical Oncology

摘　　要：目的 :探讨直肠癌保肛术后发生肠外瘘的非手术治疗方法。方法 :对 92例直肠癌保肛术后发生肠外瘘患者采用非手术综合方法治疗 ,主要措施包括 :确保骶前引流通畅有效 ;合理使用抗生素 ;根据不同病情采用进食、肠外营养、肠内营养以增强患者营养状况 ;避免不必要的肛门指检。结果 :84例治愈 ,1例改行Miles术 ,1例出现真菌性败血症而自动出院 (出院后 2个月经随访未死亡 ) ,6例行横结肠造瘘术。从瘘发生至瘘治愈拔管时间平均 17.6天 ,最短 5天 ,最长 43天。结论 :直肠癌保肛术后肠外瘘绝大部分可以用非手术治疗方法而治愈 。Objective:To summerize the clinical experience of non operative treatment of anastomotic leakage after sphinctor saving resection of rectal cancer.Methods:Ninety two cases of anastomotic leakage after sphinctor saving resection of rectal cancer were treated by non operaqtive methods including:1)Ensuring effective drainage of the presacral space.2)Appropriate use of antibiotics.3)Improving the patient′s nutritional condition (diet,parental nutrition or enteral nutrition).4)Avoiding unnecessary rectal touch.Results:Eighty four patients cured,one case reoperated(Mile′s op.),one discharged against advice and 6 cases underwent colostomy.The mean healing time was 17.6 days with the shortest healing time of 5 days and the longest time of 43 days. Conclusion:Most of the postoperative anastomotic leakages can be cured by non operative treatment.Indication of transverse colostomy should be limited.

关 键 词：直肠癌 保肛术 肠外瘘 非手术治疗 

分 类 号：R735.3[医药卫生—肿瘤]