摘要
目的:探讨膀胱结肠瘘的诊治方法,提高其诊治水平。方法:回顾性分析6例膀胱结肠瘘患者的诊治资料。男性5例,女性1例。病因为结肠癌4例、结肠憩室炎2例。临床主要表现为粪尿、气尿及反复尿路感染。通过CT确诊4例、膀胱镜确诊2例、膀胱造影确诊1例。6例全部行手术治疗,其中病变肠段切除一期吻合加膀胱部分切除术2例,膀胱瘘口外长补1例;一期横结肠造口、二期结肠癌根治加膀胱部分切除术2例;1例结肠癌患者因肿瘤有远处转移,仅行横结肠造口术。结果:6例随访5个月~3年,平均2.2年。除1例结肠癌于术后5个月死于肿瘤转移外,其他患者术后生存良好,无明显术后并发症。结论:膀胱结肠瘘主要病因为肠道病变,临床表现为反复尿路感染及粪尿等,CT三维重建为首选的检查方法,治疗以手术为主。
Objective:To assess the diagnosis and treatment of enterovesical fistula.Methods:The clinical data of 6 cases(5 men and 1 women;mean age)of enterovesical fistula were retrospectively analyzed.The etiology of fistula was intestinal malignancy in 4 cases,intestinal diverticulitis 2.The clinical features included fecaluria、recurrent urinary tract infection(UTI)and pneumaturia.Five patients(4/6)had a definite diagnosis by CT;2(2/6)by cystoscopy and 1(1/3),by cystography.Among the 6 patients undergoing surgical intervention,resection of the involved bowl with one stage anastomosis and partial cystectomy was performed in 2;resection of the bowl with one stage anastomosis and repair of the fistulain 1;one—stage transverse colostomy and two stage radical colectomy with partial cystectomy in 2 and palliative proximal colostomy in 1.Results:One patient with palliative surgery died of tumor metastasis after operation 5 months.Five patients undergoing surgery had a better survival with no complication.Conclusions:The major cause of enterovesical fistula is intestinal malignancy.Recurent UTI and fecaluria are the most common symptoms.CT three-dimensional reconstruction is the prefered adjunctive examinations.Surgical intervention is the major therapeutic choice.
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2010年第9期1442-1443,共2页
Journal of Chongqing Medical University
关键词
膀胱瘘
肠瘘
Bladder fistula
Interstinal fistula