阑尾炎术后肠外瘘处理体会

Treatment experience of enterocutaneous fistula after appendectomy

目的:探索肠外瘘的临床处理方法。方法:早期对肠外瘘进行水电解质平衡处理,尤其是积极进行引流,促进对感染的控制。中期治疗中加强营养、维护脏器功能正常、控制感染。后期主要是促进病情稳定,对瘘口不愈进行分析,选择适当方式进行手术治疗。结果:6例采用负压引流和场内外营养非手术治疗,另外6例采用手术切除治疗,全部痊愈。结论:阑尾炎术后肠瘘一般可以采用非手术引流和营养等痊愈,高流量瘘进行营养和择期手术痊愈。

Objective：To explore clinical treatment for enterocutaneous fistula. Methods：In the early stage of the treatment, water and electrolyte balance treatment was used for improving the control of the infections, especially positive drainage. In the middle stage of the treatment, it was needed to strengthen nutrition, maintain the normal organ functions, and control the infections. In the late stage of the treatment, the main purposes were to promote the stable condition, analyze the reason for the closed fistula orifice, and chose the proper operation mode. Results： 6 cases were treated with non-operative treatment like negative pressure drainage, and en- teral and parenteral nutritions, whereas the other 6 cases were treated by the surgical resection. Moreover, all the cases were recov- ered. Conclusions： The enterocutaneous fistula after the appendectomy can be treated through the non operative drainage and nutri-tions, and high flow fistulas can be healed through the nutrition and elective operation.