腹部手术后肠瘘的治疗

为提高手术后肠瘘的治愈率，作者总结了１９８９年１２月至１９９６年１０月间收治的腹部手术后肠瘘２４例，包括十二指肠瘘６例，高位小肠瘘３例，低位小肠瘘７例，结肠瘘８例。１６例行保守治疗，治愈率７５％（１２／１６）；８例行手术治疗，治愈率８７．５％（７／８）。全组死亡率２０．８％（５／２４）。作者认为治疗应遵循以下原则：（１）明确诊断；（２）结合生长抑素的应用加强营养支持治疗；（３）控制感染；（４）针对患者的具体情况，正确选择手术时机；（５）积极治疗肠道原发疾病，加强重要脏器功能的监护。

The treatment or postoperative bowel fistulas

From December, 1989 to October, 1996, 24 patients with postoperative fistulas of the bowel were treated in our department. Among them, 6 cases with duodenal fistula, 3 cases with proximal intestinal fistula,7 cases with distal intestinal fistula, 8 cases with colonic fistula.16 patients received medical therapy and 75% (12/16) were cured, the others were treated by operation with 87. 5 % (7/8) cured. The total mortality were 20. 8% (5/24). The authors believed that,in order to cure this kind of disease, the following principles should be obeyed: (1) diagnose clearly ; (2) use total parenteral nutrition combined with somatostatin ; (3) control infections; (4) select the proper time of operation ; (5)treat the primary diseases of the bowel and protect the functions of important organs.