肠外瘘661例临床分析

Enterocutaneous fistulas:A study of 661 cases

１９７１～１９９２年共治疗６６１例肠外瘘，其中５０９例（７７％）为手术引起，其余为外伤、炎性肠道疾病、放射性损伤与肿瘤所致。经治疗后，２０５例（３１．０％）的瘘口自愈，３８６例（５８．４％）手术治愈，手术成功率为９８．４６％，全组死亡率为８．６２％。作者认为当前改善肠外瘘治疗效果的关键是控制感染，强调在早期进行有效的引流，重视对器官功能的监测与维护。肠外与肠内营养支持在肠外瘘治疗中可互补其不足。肠部分切除吻合与肠浆肌层片修补术是主要的手术方式。

Abstract patients with enterocutaneous fistula treated at our hospital from 1971 to 1992were studied.Most of them were due to surgery (77%) ,the rest associated with trauma,inflammatory bowel disease,radiation lesion and tumor.As a result of therapy, 31% of fistulas closed spontaneously, 58.4% healed after operation and the total mortality was 8.62%.We considered that the key to successful management of fistula was controlling sepsis, draining the fistula in early stage,monitoring and maintaining the organs' function.Combining enteral with parenteral nutrition support may be helpful for treatment of fistula.