开放式双套管持续低负压引流治疗肠瘘合并腹腔感染(附29例报告)

Open double-lumen cannula lavage and continuous low negative pressure drainage in treatment of intestinal fistula complicated with intra-abdominal infection:A report of 29 cases

目的探讨开放式双套管持续低负压引流在肠瘘合并腹腔感染治疗中的方法和效果。方法回顾性分析2006年6月至2011年12月期间在我科住院治疗29例肠瘘合并腹腔感染患者的临床资料,29例患者均采用了开放式双套管持续低负压引流。结果 24例患者直接更换开放式双套管,并予以持续低负压冲洗引流后腹腔感染得到控制,瘘口自行愈合。5例患者因经引流3~5天后仍出现高热、弥漫性腹膜炎症状无明显好转而再次手术治疗,术中重新放置开放式双套管,术后行持续冲洗引流,其中3例治愈,1例患者因继发多器官功能脏器衰竭而死亡,1例自动出院。结论开放式双套管持续低负压引流技术治疗肠瘘合并腹腔感染具有显著的疗效。明显降低了再次开腹手术率和死亡率。

Objective To explore the method and effect using open double-lumen cannula lavage and continuous low negative pressure drainage in treatment of intestinal fistula complicated with intra-abdominal infection.Methods Retrospective analysis was conducted on the clinical data of 29 patients with intestinal fistula complicated with intra-abdominal infection who received treatment in our hospital from June 2006 to December 2011.All of the 29 patients were administered the technique of open double-lumen cannula lavage and continuous low negative pressure drainage.Results Twenty-four patients had direct open double-lumen cannula lavage,and the intra-abdominal infection was controlled with continuous low negative pressure drainage.The fistula then healed naturally.Five patients had symptoms of high fever and diffusive peritonitis after drainage of 3 to 5 days and had to receive surgery again.Intraoperative replacement of open double-lumen cannula and postoperative drainage were then conducted.Three patients were cured and 1 patient died due to multiple organ failure.One patient voluntarily left hospital.Conclusion Open double-lumen cannula lavage and continuous low negative pressure drainage can yield remarkable therapeutic effect on intestinal fistula complicated with intra-abdominal infection,and significantly decrease the need for a second surgery and mortality rate.