放射损伤性瘘

介绍了８例放射损伤性肠瘘病例，并对其特点、治疗方法等进行了讨论。该病除具有其他原因所致肠瘘的病理生理改变如营养不良、内稳态失衡、感染等外，尚有组织愈合能力差，腹腔粘连严重、腹壁瘢痕化、病变呈进行性、复杂瘘较多等特点，使该病的治疗基为困难。故围手术期的营养支持更为重要，可提高手术成功率，降低并发症。但营养支持难以使瘘口自愈，必须进行肯定性手术。对于单发瘘，应尽量行肠瘘切除肠吻合术，粘连严重者可酌情行

ENTERAL FISTULAE CAUSED BY RADIOTHERAPY

This article covers eight cases of enteral fistula which were caused by radiotherapy. The features of these cases are discused and suggestions for their treatment are proposed. Apart from typical pathophysiolgic changes in common enteral fistulae, such as malnutrition, imbal- ance of internal environment, infection etc,the cases studied are also characterized by poor healing of tis- sue, severe adherence in abdominal cavity, cicatrization of abdominal wall, progressive pathological changes and complicated fistulae et al. All these complications make the treatment more difficult. Therefore, the author considers that nultritional suppout is more important for this kind of enteral fistulae. Not only can it improve success rate of the operation, but also decrease occurrence of complications, But the nultritional support can hardly make the fistulae spontaneously healing, thus surgical oper- ations must be done. Specific operations are suggested for various types of fistulae, As for monofistula , the resection of enteral fistula and enteroanastomosis may be the best treatment; For fistula with severe adherence , by pass operation is suggested; For complicate fistula, by pass operation may still be the choice because of its complexity; For fistula of bladder, a vesicostomy above pubic is advised,