妇科恶性肿瘤术后肠瘘4例分析

目的：分析妇科恶性肿瘤手术后肠瘘发生的原因和治疗。方法：回顾性分析妇科恶性肿瘤手术后4例肠瘘的临床资料，平均年龄49岁。卵巢癌3例，子宫内膜癌1例，均为Ⅱc期以上。2例为初次手术，2例为再次手术。4例术前均有贫血和低蛋白血症，术后均有低热、腹部切口感染，分别于术后11、10、14和12天出现肠瘘，4例均行保守治疗。结果：4例分别于术后18、32、42、31天经保守治疗后肠瘘愈合。结论：肠瘘多发生于困难的妇科恶性肿瘤手术之后，临床表现为低热、腹部切口溢液、肠内容物自切口排出，治疗以保守治疗为首选。

Analysis of 4 Intestinal Fistulas after Gynecological Surgery

Objective:To assesses the diagnosis and treatment of intestinal fistula after gynecological oncology surgery.Methods:The clinical data of 4 cases of intestinal fistula were retrospectively analyzed.Results:The mean age were 49 years old.Of 4 cases,3 were with ovarian cancer and one with endiometrical cancer.Two fistulas happened after first operation and another two occurred after the second operation.All of the 4 cases had preoperative anemia and hypoproteinemia.The fistulas were diagnosed on the 11th,10th,14th,12th day after operation respectively.All of the 4 cases were cured by conservative therapy.Conclusion:The cause of intestinal fistula is difficult gynecological tumor surgery.Clinical manifestations were low-grade fever,abdominal incision polyrrhae and intestinal contents row from abdominal incision.The conservative treatment was the first choice.