【摘要】 目的 探讨腹部手术后并发肠瘘的治疗方法。方法 回顾性分析我院2004年1月至2009年12月收治的腹部手术后并发肠瘘39例临床资料治疗及总结经验。结果 高位肠瘘16例,低位肠瘘23例,其中18例手术治疗,21例保守治疗,32例治愈,5例死亡,2例放弃治疗。结论 保持引流通畅,充分引流,经过控制感染及肠内外营养支持、使用生长抑素和生长激素等措施,根据发现瘘的时间早晚、瘘的性质、患者身体状况、保守治疗效果而决定行确定性手术治疗,能提高肠瘘的治愈率及降低死亡率。

    【关键词】肠瘘;充分引流;营养支持;控制感染;手术治疗

    The therapeutic analysis of intestinal fistula After abdominal surgery (A report of 39 cases)

    WEN Zhi qiang,SONG Yue.General Surgery Dept.I,Meizhou People’s hospital,Guangdong,Meizhou 51400,China

    【Abstract】 Objective To discuss the treatment of intestinal fistula after abdominal surgery.Methods From January 2004 to December 2009,39 cases with intestinal fistulas f postoperative abdominal surgery were analyzed retrospectively.Results 16 case were upper intestinal fistula and 23 cases belonged to lower intestinal fistula,18 of whom were cured by surgical treatment,21cases cured by conservative treatment.32 of them have recovered; 5 died;2 of them gave up taking treatments.Conclusion Carry out thorough drainage,control of infection,suitable support of nutrition,somatostatin and growth hormone.Whether to carry out surgical treatment or not was decided according to the time when the intestinal fistula was found,feature of the intestinal fistula,condition of the patient,effects of the conservative treatment,which can increase the recovery rate and reduce the mortality rate. ......