介入下置管引流联合臭氧治疗腹部手术后肠外瘘临床疗效研究

A clinical efficacy study of interventional catheter drainage combined with ozone therapy for the management of postoperative enterocutaneous fistula

目的:探讨介入下置管引流联合臭氧治疗腹部手术后肠外瘘的临床疗效。方法:将70例腹部手术后肠外瘘患者分成2组:A组35例,行常规外科治疗;B组35例,予介入下置管引流+臭氧治疗。比较两组有效率、住院时间、费用及并发症等。随访观察治疗前及治疗后3d、1周、2周和1个月感染评分变化。结果:A组痊愈30例(85.7%),B组28例(80.0%),两者差异无显著性。B组患者住院时间和费用均明显低于A组。A组切口并发症4例,腹腔出血2例,重症肺炎及感染性休克各1例;B组2例患者出现腹部绞痛,两者比较有显著差异。感染评分经重复测量方差分析,组间无统计学意义;治疗前后差异有显著性,A组治疗前后平均降低19.9,B组为23.5,表明B组抗感染效果优于A组。结论:介入下置管引流联合臭氧治疗腹部手术后肠外瘘安全有效,能明显缩短患者住院时间,降低费用,是安全有效的方法。

Objective To evaluate the efficacy of interventional catheter drainage combined with ozone therapy for the management of postoperative enterocutaneous fistula. Method A total of 70 patients with postoperative enterocutaneous fistula were enrolled and divided into group A（35, conventional surgical treatment）and group B（35, interventional catheter drainage and ozone therapy）. Clinical efficiency, hospital stays, hospital expenses and complications were compared. Follow-up observations of the infection score in 2 groups before and after treatment（3 days, 1 week, 2 weeks and 1 month） were also compared. Results 30 cases in group A recovered（85.7%）, and 28 cases in group B recovered（80.0%）, the result of which shows no statistic significance. The hospital stays and expense in group B were significantly lower than those in group A. 4 cases of group A suffered from incision complications, 2 intra-abdominal hemorrhage, 1 severe pneumonia and 1 septic shock. 2 cases in group B suffered from stomachache. The differences can be shown significantly. The infection scorebetween the two groups shows no significant difference, but the score was found to be obviously lower after treatment than before. The infection score decreased by an average of 19.9 in group A and 23.5 in group B,indicating a better anti-infective effect in group B. Conclusion Interventional catheter drainage combined with ozone therapy for the management of postoperative enterocutaneous fistula is safe and effective, with lower hospital stays and expense.