应用不同类型引流装置治疗创伤后肠瘘的对比研究

目的观察和评价采用不同类型引流装置治疗肠瘘的临床效果。方法回顾性分析2012年1月—2016年12月广西医科大学第一附属医院肝胆外科收治的63例创伤性及医源性肠瘘患者,其中男性38例,女性25例;年龄20~78岁,平均48岁。对采用普通引流管(A组)、VSD管(B组)、双套管冲洗引流管(C组)患者的临床资料及治疗效果进行比较。结果 B组引流管留置时间(25.6±7.8)d短于A组引流管留置时间(34.5±12.8)d;C组应用抗生素时间为(15.9±7.9)d,较A组(22.1±13.2)d使用抗生素时间短;C组平均住院日(32.0±14.9)d、恢复肠内营养时间(5.1±3.0)d、引流管留置时间(24.5±5.8)d均短于A组(32.0±14.9)d、(5.1±3.0)d、(24.5±5.8)d(P0.05)。结论相对于普通引流管,双套管引流和VSD管在治疗肠瘘时,更能充分发挥外科引流新技术的优势,能减少患者痛苦,提高治疗效果,缩短住院时间,减少治疗费用。

To compare the treatment of intestinal fistula by using different types of drainage devices

Objective To observe and evaluate the clinical effect of intestinal fistula after treating with different types of drainage devices.Methods Data of 63 cases of intestinal fistula who were admitted into our hospital from Jan.2012 to Dec.2016 was retrospectively analyzed.There were 38 males and 25 females,with a mean age of 48 years (range,20 to 78 years).Patients were divided into three groups: group A,using ordinary plasma drainage tube,group B,using VSD negative pressure drainage;group C,using double pipe flushing drainage tube.The clinical data and therapeutic effect were compared among three groups.Results The drainage tube indwelling time of group B ((25.6±7.8)d) was shorter than that of group A ((34.5±12.8)d);the antibiotics application time of group C ((15.9±7.9) d) was shorter than that of group A ((22.1 ±13.2) d);the average hospitalization,the recovery time of enteral nutrition and the drainage tube indwelling time in group C was (32.0±14.9)d,(5.1±3.0)d,(24.5±5.8)d ,respectively,which were shorter than those of group A ((32.0±14.9)d,(5.1±3.0)d,(24.5±5.8)d,P＜0.05).Conclusion Double pipe flushing drainage is an effective means for treatment of intestinal fistula.It is more efficient in pain relief,treatment improvement,hospital stay redcution and cost reduction.