肠外营养支持治疗消化道外瘘17例报告

目的总结消化道瘘的临床治疗，尤其是肠外营养应用的经验。方法分析消化道外瘘17例的临床及治疗经过，其中16例为高流量瘘，8例属难治性瘘，瘘流量平均为1061ml／d。PN支持平均39．5天，最长218天。结果瘘口自然闭合10例(58．8％)，PN期间手术闭合4例(23．5％)，死亡2例(11．8％)。结论PN对于促进消化道瘘自然闭合，以及难治性瘘赢得时机手术闭合，都具有不可取代的治疗意义。

PN support in the management of external fistula of alimentary tract--A report of 17 cases

Objective To summerise our experience of nutritional support in the management of external fistulas of the alimentary tract. Methods A series of 17 patients with external fistulas of alimentary tract is presented, of whom 16 were high output and 8 belonged to intractable complicated fistulas. The mean output of each fistula was 1061ml/d. The mean duration of PN support for each patient was 39.5 days and the longest one maintained for 218 days. Results The fistulas healed spontaneously in 10 cases(58.8%). Operative resection of fistulous segments during the time of PN were successful in 4 cases(23.5%). Two died(11.8%). Conclusions Pancreatic fistulas, complicated external fistulas, labial fistulas of which the mucous membrane were valgus and fistulas of specific etiology(tuberculosis,grastrinoma,etc.) were all hardly healing spontaneously. PN was an essential treatment for patients with external fistulas of alimentary tract. It not only encouraged the spontaneous closure,but also won the time for surgical clusure of intractable fistulas.