肠道膀胱内瘘12例临床分析  

Diagnosis and treatment of enterovesical fistula:report of 12 cases

作　　者：宋世铎[1] 唐悠远 蒋林华[1] 朱新国[1] Song Shiduo;Tang Youyuan;Jiang Linhua;Zhu Xinguo(Department of General Surgery,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院普通外科,苏州215006

出　　处：《中华普通外科杂志》2023年第11期819-821,共3页Chinese Journal of General Surgery

摘　　要：目的探讨肠道膀胱内瘘的诊断和处理方法。方法回顾性分析2012年1月至2021年12月期间苏州大学附属第一医院诊断肠道膀胱内瘘12例患者的临床资料。结果12例患者中直肠膀胱瘘5例,乙状结肠膀胱瘘4例,盲肠膀胱瘘1例,回肠膀胱瘘2例,其中1例女性患者并存阴道膀胱瘘。行CT检查6例,肠镜检查5例,膀胱镜检查6例,膀胱X线造影检查3例,肠道X线造影检查2例。11例接受手术治疗,5例为2次以上手术。1例术后死亡,2例行肠造口术后好转。1例行病变肠管切除术、膀胱修补术,3例行病变肠管切除联合部分或全膀胱切除术,4例行病变肠管切除、膀胱修补、横结肠或回肠造口术。全组12例患者中,1例术后死亡,1例未愈,10例痊愈,随访至今无复发。结论肠道膀胱内瘘多继发于肠道肿瘤,临床表现大多为粪尿、尿路感染,CT、膀胱镜、膀胱X线造影或肠道X线造影检查为重要诊断手段,手术治疗效果良好。Objective To explore the diagnosis and treatment of enterovesical fistula.Methods The clinical data of 12 patients with enterovesical fistula at the First Affiliated Hospital of Soochow University from Jan 2012 to Dec 2021 were retrospectively analyzed.Results There were 5 cases of rectovesical fistula,4 cases of sigmoid colovesical fistula,1 case of cecovesical fistula,and 2 cases of ileovesical fistula,with 1 female patient having concurrent vaginal vesical fistula.CT was carried out in 6 cases,enteroscopy in 5 cases,cystoscopy in 6 cases,cystography in 3 cases,and enterography in 2 cases.Eleven cases underwent surgical treatment,1 case did not.Five cases underwent more than two operations,1 case still had enterovesical fistula and died after ileostomy,2 cases improved after enterotomy.One case underwent bowel resection and bladder repair and 3 cases underwent bowel resection and anastomosis combined with partial or total cystectomy,4 cases underwent bowel resection,bladder repair,transverse colon or ileostomy.One died,1 case still had enterovesical fistula and 10 cases were cured.There were no recurrence on follow-up.Conclusions Enterovesical fistula is often secondary to intestinal tumors,and its clinical manifestations are mostly fecaluria and urinary tract infections.CT,cystoscopy,cystography and enterography are important diagnostic methods.Surgical treatment is the choice of therapy.

关 键 词：肠瘘 膀胱瘘 

分 类 号：R656[医药卫生—外科学]