三腔二囊管早期确定性手术治疗实验犬十二指肠瘘的研究

Sengstaken-Blakemore tubes for balloon tamponade in early definitive surgery for duodenum fistulas in dogs

目的研究实验犬十二指肠瘘发生早期,应用三腔二囊管肠腔内填塞隔离消化液修补瘘口治疗肠瘘的手术效果。方法将实验犬随机分为三腔管组(A组)、早期手术组(B组)、保守治疗组(C组)、对照组(D组)4组,每组各8只,应用不同方法并结合使用抗生素、生长抑素及全肠外营养治疗,比较各组肠瘘愈合时间及体质量变化、医疗费用、术后并发症发生情况。结果4组犬均治愈。三腔管组肠瘘愈合时间为(7.0±0.8)d,明显短于其他组(P<0.01),体质量变化最小,治疗费用最少,术后并发症发生率最低。结论在实验犬十二指肠瘘发生早期,应用三腔二囊管肠腔内填塞隔离消化液行早期确定性手术修补瘘口能有效缩短肠瘘愈合时间,减少医疗费用,术后并发症少,是一种很有应用前途的肠瘘治疗方法。

Objective It is to investigate the effects of the early definitive surgery with Sengstaken-Blakemore tubes used for balloon tamponade to isolate digestive juice in the bowels in the management of dogs with duodenum fistulas. Methods 32 Beagle dogs were randomly divided into 4 groups： early surgery with Sengstaken-Blakemore tubes（ Group A）, routine early surgery（Group B） , eonservative treatment group（Group C） and control group （Group D）. They were treated with different methods and/or given antibiotics, Octreotide and total parenteral nutrition. Some clinical factors such as healing time of fist tulas, body changes, postoperative complications and medical expenditure were compared. Results The duodenum fistulas of all the dogs healed after operative or conservative treatment. The mean healing time of duodenal fistulas was （7.0 ± 0.8）d in Group A, and was the shortest in all groups（P 〈 0.01 ）. So were the decrease of weigh and expenditures on treatment, occurrence rate of postoperative complications. Conclusions The healing time, expenditures and postoperative complications can be reduced using Sengstaken - Blakemore tubes for balloon tamponade in early definitive surgery for dogs with duodenal fistulas in early stage, which can be acted as a useful therapeutic method for duodenal fistulas.