肠外瘘早中期确定性外科处理的临床研究

Surgical management of early or medium term entrocutaneous fistulas

目的探讨肠外瘘早中期确定性处理方法。方法对３１例肠外瘘病人的治疗经验进行分析。在重视综合措施的前提下，对无法确定可否自愈的２８例病人，应经过必要准备后，争取早期手术治疗，并根据术中发现的情况，采用不同手术方法。另３例瘘口较小者采用非手术症法。结果３例非手术治疗者均自愈。可２８例手术治疗者中，治愈２６例（９３６％），死亡２例（６４５％）。平均住院日期３６２２ｄ。结论在大多数肠瘘病人，采取早期手术治疗肠外瘘，可取得缩短病程。

Objective To search the definite management of early and medium stage entrocutaneous fistula(ETF). Methods The experience in treatment of 31 cases of ETF was analysed. For 28 patients with intestinal fistula uncertainly spontaneously closed, an operation was carried out as soon as possible; and the operations adopted were according to the patients' general and local conditions. Of course, a proper preoperative preparation was needed. The other 3 cases with smaller intestinal fistulas were treated non operatively. Results In 3 patients with non operative treatment, the fistulas were closed spontaneously. Among 28 patients surgically treated, 26 patients(93.6%) curred and 2(6.4%) died. The average hospitalization was 36.22 days in this series. Conclusions For most patients with intestinal fistula, early exploratory laporatomy with different operative procedure can get successful results.