腹部手术后并发肠瘘治疗方案的选择(附肠瘘早期手术修补24例报告)

Treatment project selection of intestinal fistula complicated by abdominal surgery (24 cases report on early surgical repair of intestinal fistula)

目的 对腹部手术后肠瘘的发生原因、发展过程、治疗方法及其疗效进行研究 ,探讨其合理的治疗方法。方法 收集我院 1997年 10月 - 2 0 0 2年 12月间与肠道有关的腹部手术 6 2 0例 ,有 11例发生肠瘘 ,外院术后疑肠瘘转我院后确诊 19例 ,共计 30例。对肠瘘者的一般情况、疾病诊断、手术经过、肠瘘发生的时间、诊断依据、治疗方法和疗效进行了回顾研究。结果 本组与肠道有关的腹部手术肠瘘发生率为 1.77%。 2 4例早期修补术 ,本组治愈 2 2例 (91.6 7% ) ,死亡 2例 (8.33% )。 6例保守治疗 ,本组治愈 5例 (83.33% ) ,死亡 1例 (16 .6 7% )。结论 肠瘘大多宜行早期修补手术 ,提高了治愈率 ,缩短了住院日期 ,减少了病死率。

Objective To search proper treatment method of intestinal fistula by studying the cause , advance , treatment measure and its effect about intestinal fistula after abdominal operation.Methods From October 1997 to December 2002 , 620 cases of abdominal surgery , which related to intestine , were gathered in our hospital. Of 30 cases , including 11 cases of intestinal fistula , 19 cases determined its diagnosis in our unit when they were suspected as intestinal fistula after other hospital operation . The general state , diagnosis , surgical process , suffering time , diagnosis gist , treatment methods and its effect of these patients were reviewed.Results In this group , 1.77% intestinal fistula complicated by abdominal operation involving intestine. In 24 cases of early repairing , 22 (91.67 %) cured , 2 (8.33%) died . In 6 cases of non-operation , 5 (83.33%) cured , 1 (16.67%) died.Conclusion Early operation must be implemented in intestinal fistula , improving healing level, shortening admitting times , reducing died scale. [