腹部手术后并发肠瘘的临床治疗分析

Clinical analysis of intestinal fistula complications after abdominal surgery

目的观察不同方法治疗腹部手术后并发肠瘘的临床疗效。方法选取40例腹部手术后并发肠瘘患者作为研究对象,随机分为对照组和试验组,每组20例。对照组患者给予直接手术治疗,试验组患者给予清创、负压引流、控制腹腔感染、营养支持等治疗7 d后再进行手术治疗。观察两组患者的下床时间、肠功能恢复时间、住院总时间、第7天创面愈合情况、临床治愈率。结果治疗后,试验组患者下床时间、肠功能恢复时间、住院总时间短于对照组(P<0.05);试验组患者第7天创面愈合情况优于对照组(P<0.05);试验组患者临床治愈率高于对照组(P<0.05)。结论腹部手术后并发肠瘘术前1周给予清创、引流等保守治疗后再行手术,相比于直接手术治疗,可缩短患者恢复时间,提高治愈率,值得临床推广。

Objective To observe the clinical effect of different ways on intestinal fistula complications after abdominal surgery. Methods Forty patients with intestinal fistula complications after abdominal surgery admitted in our hospital were selected and randomly divided into control group and experimental group, with 20 cases in each group. The control group was given direct surgical treatment, and the experimental group was treated with surgical treatment after debridement, the negative pressure drainage, control of the abdominal cavity infection, nutritional support for 7 days before treatment. The ambulation time, postoperative bowel function recovery time, hospitalization time, wound healing of 7 days and the cure rate of the two groups were observed. Results After treatment, the ambulation time, bowel function recovery time and hospitalization time of the experimental group were shorter than those of the control group（P〈0.05）. The wound healing of7 days of the experimental group was better than that of the control group（P〈0.05）. The cure rate of the experimental group was higher than that of the control group（P〈0.05）. Conclusion Compared with direct surgical treatment, to give debridement,the negative pressure drainage for 7 days before surgical treatment can reduce the patients＇ recovery time and improve the cure rate, which is worthy of popularization in clinic.