82例术后低位直肠瘘治疗的最佳方法探讨

目的研讨研究82例术后低位直肠瘘治疗的最佳方法。方法本院收集术后发生低位直肠瘘的患者的临床资料总计82例,随机分为实验组和对照组,每组各41例。实验组采用腹膜腔冲洗引流管术,在此治疗基础上给予生长抑素大剂量奥曲肽,对照组给与全肠外营养支持治疗和抗生素治疗,比较两组患者的治疗效果,包括治愈率、愈合时间、二次手术率以及死亡率,分析两组患者的治疗前后的肠瘘引流量和引流量下降率。结果实验组的治愈率与对照组相比显著增高,而愈合时间、二次手术率明显低于对照组。两组治疗后的肠瘘引流量明显低于治疗前,差异无统计学意义。实验组的肠瘘引流量与对照组比较显著下降,而引流量下降率与对照组比较明显升高,P均〈0.05,具有统计学意义。两组患者的死亡比较差异无统计学意义（P〉0.05）。结论腹膜腔冲洗引流管术和生长抑素奥曲肽的联合使用对于治疗术后低位直肠瘘是有效的最佳方法,具有治愈率高、愈合时间短、二次手术率和死亡率低的特征,值得在临床上推广使用。

Explore best solutions for of postoperative rectal fistula in 82 cases

Objective To explore best solutions for of postoperative rectal fistula. Methods The clinical data from 82 cases of the patients with postoperative rectal fistula in our hospital were chosen and divided into two groups randomly ：the experiment group and the control group. The experimental group was treated with peritoneal cavity drainage tube technique, based on the somatostatin and octreotide; the control group was treated with total parenteral nutrition support treatment and antibiotic treatment. Clinical effects of two groups were compared, including the cure rate, healing time, two secondary operation rate and mortality rate; the intestinal fistula drainage and drainage rate of decline of two groups before and after treatment were analyzed. Results The cure rate of the experimental group significantly increased compared with the control group, while the healing time, the two operation was significantly lower than those of the control group. The intestinal fistula drainage volume of the experimental group decreased significantly compared with the control group, and the drainage rate were higher than control group＇s, P0.05, with statistical significance. Significant mortality was not find between the two groups （P0.05）. Conclusion The combination of peritoneal cavity drainage tube technology the somatostatin octreotide is the best solution to postoperative rectal fistula： it has a high cure rate, short healing time, characteristics with low two operation rate and mortality rate, which is worth widely using in clinical.