双套管持续冲洗负压吸引法治疗术后急性肠瘘的临床分析

Therapeutic analysis of the double catheterization cannula persistent bathe and vacuum aspiration to treat acute intestinal fistula after abdominal surgery

目的:探讨双套管持续冲洗负压吸引引流法治疗腹部外科手术后肠瘘的技术要点、优势及经验。方法:回顾性分析中国医科大学附属第四医院2009年7月—2012年11月收治的外科手术后急性肠瘘的患者21例,所有患者均应用双套管持续冲洗负压吸引引流法治疗。结果:1例死于肿瘤晚期全身衰竭,1例中途放弃治疗,其余19例均治愈,患者多于双套管持续冲洗负压吸引引流后1～3 d停止发热,腹腔感染得到有效控制。引流后15～35 d,肠瘘自行愈合拔管。出院后随访6个月,患者均恢复良好,无并发症发生。结论:术后急性肠瘘一旦发现应及时采用双套管持续冲洗负压吸引引流并联合其他保守治疗方法,多能取得满意疗效。

Objective： To study security, feasibility, forte and technical point of the double catheterization cannula persistent bathe and vacuum aspiration to treat acute intestinal fistula after abdominal surgery. Methods： The data of 21 patients from June 2009 to December November 2012 were analyzed retrospectively. Resultx： One case died because of malignant tumor; 1 case to give up healing; 19 cases were cured by conservative treatment. 1 - 3 days after active drain ,the fever was abolition; 15 · 36 days after active drain the intestinal fistula was accrete. Postoperatively 6 months following up no recent complications and no recidivation. Conclusions： When find the intestinal fistula after abdominal surgery, immediately use the double catheterization cannula persis- tent bathe and vacuum aspiration to active drain and combinate other conservative treatments, can gain satisfactory curative effect.