【摘要】 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:调查了1992年9月至2001年9月间与肠道有关的腹部手术2056例,共有38例发生肠瘘。对肠瘘者的一般情况、手术过程、肠瘘发生时间、诊断依据(症状、体征及有关检查)、治疗方法和疗效进行回顾研究。结果:本组与肠道有关的腹部手术发生率为1.85％。高位肠瘘14例,8例早期手术修补术仅1例成功,6例保守治疗5例治愈。低位肠瘘24例,其中12例行肠造口粪便转流术8例痊愈,另12例保守治疗10例成功,2例死亡。结论:肠外瘘大多宜保守治疗,早期修补手术不易成功;有弥漫性腹膜炎者,及时行冲洗引流、粪便转流手术,可以降低死亡率。更多还原

【Abstract】 Objective To study the cause of disease, clinical development, treatment and theraeutic effect of the intestinal fistula after abdominal operation, explore the reasonable treatment. Methods 2056 case of intestinal diseases undergoing abdominal operation, between Sep,1992 and Sep,2001 were studied, and postoperative intestinal fistulas were found in 38 cases. The clinical features,diagnosis,operation,duration of symptom,diagnosyic basis(symptom and examination) , treatment and therapeutic effect of the cases were studied retrospectively. Results the rate of postoperative intestinal fistula was 1. 88% in this group. Only 1 of 8 cases treated with early repair of operation and 5 of 6 cases with conservative methods were cured in 14 cases of high intestinal fistulas. 8 of 12 patients undergoing diversion enterostomy and 10 of 12 patients with conservative treatment were cured in 24 cases of low intestinal fistulas. Conclusion Conservative treatment is suitalble in most of intestinal fistulas, early repair is often unsuccessful. Douche, drainage and fecal diversion in time can lower the mortality of those with diffuse peritonitis.更多还原