双套管持续冲洗负压引流治疗腹膜癌术后胃肠瘘  

A double-catheter washing and aspiration system for the treatment of gastrointestinocutaneous fistula after peritoneal cancer resection

作　　者：张彦斌[1] 姬忠贺[1] 刘刚[1] 于洋[1] 李兵[1] 李鑫宝[1] 王岩[1] 张展志[1] 李雁[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院腹膜肿瘤外科,100038

出　　处：《中华普通外科杂志》2017年第6期505-507,共3页Chinese Journal of General Surgery

基　　金：首都临床特色应用研究与成果推广基金资助项目（Z16110000016077）;首都医科大学附属北京世纪坛医院重点学科发展基金资助项目（2016fmzlwk）

摘　　要：目的本研究旨在探讨自制双套管冲洗法治疗肿瘤细胞减灭术（cytoreductive surgery，CRS）联合腹腔热灌注化疗（hyperthermic intraperitoneal chemotherapy，HIPEC）后胃肠瘘的临床意义。方法回顾性分析2015年4月至2017年1月在北京世纪坛医院行CRS＋HIPEC治疗后发生胃肠瘘13例患者的临床资料，所有患者在发生胃肠瘘后即刻采用自制双套管冲洗方法治疗，同时联合抗感染、营养支持及其他保守治疗。结果本组13例胃肠瘘患者均进行了双套管持续冲洗负压引流加保守治疗，治愈8例，瘘愈合的中位时间为50 d（12～84 d）；临床明显改善3例，漏出量明显减少、一般状况明显改善；死亡2例。结论持续双套管冲洗负压引流是治疗CRS＋HIPEC后胃肠瘘的一种简单、有效的方法。Objective To evaluate double catheterization of cannula persistent irrigation and negative pressure system to treat gastrointestinocutaneous fistula （GIF） after cytoreduetive surgery plus hyperthermic intraperitoneal chemotherapy for peritoneal cancer. Methods A self-made double catheterization of cannula persistent bathe and negative pressure system was implanted into the site of fistula, to ensure efficient drainage. The patient was treated with anti-sepsis, nutrition support and other conservative measures. Results GIFs occurred in 13 patients. The negative pressure drainage system was successfully implanted into the fistula site to keep an efficient drainage. By this conservative treatment fistula healed in 8 patients after 50 days （range 12 to 84 days）. In other three patients fistula output significantly reduced and general conditions greatly improved. The mortality rate was 15% （2/13）. Conclusion The double catheterization of cannula persistent bathe and negative pressure aspiration system is a simple and efficient method to treat GIF.

关 键 词：腹膜肿瘤 消化系统瘘 双套管引流 

分 类 号：R735.5[医药卫生—肿瘤]