慢性腹壁窦道与腹腔瘘管的病因机制及治疗方法

Mechanism and treatment of chronic abdominal wall fistula and abdominal fistula

目的探讨慢性腹壁窦道与腹腔瘘管的病因机制及手术治疗方法。方法回顾性分析2000年10月至2012年10月,涿州市医院收治的慢性腹壁窦道、瘘管患者54例的临床资料。针对不同的情况进行经过局部手术切除或者探针探查窦道并刮除窦道壁炎性组织后切除等方法。经银质探针和窦道、瘘管X线造影检查进一步确诊。全组患者均在硬膜外间隙阻滞麻醉下行窦、瘘道切除。结果 53例患者经过不同方法的手术治疗及抗炎等对症处理后获痊愈,1例患者因恶性肿瘤术后复发。结论沾染切口和无菌技术的不严格是导致慢性腹壁窦道切除术形成和瘘管发生的主要原因,治疗应在非急性炎性反应期行规范性切除及其相应处理。

Objective To explore the mechanism and treatment of chronic abdominal wall fistula and abdominal fistula. Methods A total of 54 cases with chronic abdominal wall fistula were enrolled in the Zhuozhou City＇s Hospital from October 2000 to October 2012 and retrospectively analyzed. The local operation resection or Sinus wall with probe or inflammatory tissue excision were applied. The silver probe, X-ray examination and sinus fistula were used for diagnosis. All the patients were treated with epidural space block anesthesia and sinus fistula was resected. Results Fifty-three patients were cured after different methods of operation, anti-inflammatory and other treatments for symptoms. One ease of tumor was recurred after operation. Conclusions The incision and relative low-standard aseptic technique are the main causes for resections of chronic abdominal wall sinus and fistula, which should be resected and treated in the non-acute inflammation stage.