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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1993年10月至2000年10月间与肠道有关的腹部手术1816例，共有34例发生肠瘘。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（症状、体征及有关检查）、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1.88%。高位肠瘘13例，7例早期修补术仅1例成功，6例保守治疗5例治愈。低位肠瘘21例，其中10例行肠造口粪便转流术7例获愈，另11例保守治疗9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。

Exploration of surgical treatment for intestinal fistula:report of 34 cases.

Objective To study the cause of disease,clinical development,treatment and therapeutic effect of the intestinal fistula after abdominal operation,explore the reasonable treatment.Methods 1816 cases of intestinal diseases undergoing abdominal operation between Oct,1993 and Oct,2000 were studied,and postoperative intestinal fistulas were found in 34 cases.The clinical features,diagnosis,operation,duration of symptom,diagnostic basis(symptom and examination),treatment and therapeutic effect of the cases were studied retrospectively.Results The rate of postoperative intestinal fistulas was 1 88% in this group.Only 1 of 7 cases treated with early repair of operation and 5 of 6 cases with conservative methods were cured in 13 cases of high intestinal fistulas.7 of 10 patients undergoing diversion enterostomy and 9 of 11 patients with conservative treatment were cured in 21 cases of low intestinal fistulas.Conclusion Conservative treatment is suitable 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.