膀胱肠瘘的诊断与治疗(附11例报告)  

Diagnosis and therapy of vesicoenteric fistula(11 cases)

作　　者：江伟凡[1] 史子敏[1] 习小庆[1] 潘正跃[1] 熊建华[1] 刘芳明[1] 刘晓强[2] 孙光[2] 

机构地区：[1]南昌大学第二附属医院泌尿外科,江西南昌330006 [2]天津医科大学第二医院泌尿外科,天津300211

出　　处：《中国现代医学杂志》2014年第24期95-97,共3页China Journal of Modern Medicine

摘　　要：目的探讨膀胱肠瘘的临床特点,提高膀胱肠瘘的诊治水平。方法回顾性分析11例膀胱肠瘘患者的临床资料。10例患者接受手术,保守治疗1例。结果 10例患者随访3个月-10年,平均3.8年,1例失访。癌性患者8例,7例接受随访,1例术后4个月死于全身脏器功能衰竭,2例分别于术后18及25个月死于全身多发转移,1例术后2年死于心脏病,另外3例存活良好,仍在随访中。结肠憩室炎患者2例存活良好,仍在随访中。1例克罗恩病患者术后5年复发、再次手术后生存良好。结论膀胱肠瘘主要临床表现为粪尿、反复尿路感染、气尿等;常见病因有憩室炎、结肠直肠癌和克罗恩病等;CT、膀胱镜是主要的检查方法;手术仍是主要的治疗方法,且常需多学科联合手术;预后与病因密切相关。【Objective】To study the clinical features of vesicoenteric fistula and to improve the diagnosis and treatment of this disease. 【Methods】11 cases of vesicoenteric fistula were reviewed and analyzed. 10 patients accepted surgery, 1 case accepted conservative therapy. 【Results】During the whole follow-up, 1 case was lost, 10 cases were in control, follow-up times ranging from 3 months to 10 years（mean 3.8years）. 7 cases of the whole 8cancer patients accepted follow-up, 1 case died of multiple organ dysfunction syndrome 4 months after surgery;2cases died of tumor metastasis 18 months and 25 months after surgery;1 case died of heart disease 2 years after surgery; the other 3 cases were still alive.2 cases of intestinal diverticulitis were still alive with no recurrence.1 case of Crohn disease had intestinal fistula recurrence 5 years after surgery and was cured with reoperation.【Conclusion】The common clinical features of vesicoenteric fistula included fecaluria, recurrent urinary tract infection and pneumaturia. The common etiology of vesicoenteric fistula was intestinal diverticulitis, intestinal malignancy and Crohn disease. CT and cystoscpoy was the main diagnostic method. Surgery was still the main therapy and often needed the cooperation of multidisciplinary. The prognosis was closely related with the etiology.

关 键 词：膀胱肠瘘 外科手术 

分 类 号：R694[医药卫生—泌尿科学]