高排性十二指肠外瘘18例临床研究

目的：分析高排性十二指肠外瘘发生的原因，探讨其诊断及治疗方法。方法：对18例高排性十二指肠外瘘病人，分析其发生的原因。诊断，临床表现及采取的治疗措施。结果：18例患者均为手术后并发症，确诊时间为手术后2-14天。所有病例均行禁食，胃肠减压，维持水，电解质平衡，抗感染，通畅引流等一般治疗。7例瘘口自然关闭，8例手术治疗，其中6例早期手术，5例获治愈；2例晚期手术，均获治愈。3例死亡，结论：手术是导致高排性十二指肠外瘘的主要原因。非手术治疗对治愈性手术前是必须的，如非手术治疗效果不佳可以考虑早期手术。

Clinical study of high output duodenocutaneous fistula in 18 cases.

Objective:To analyse the occurrence cause of high output duodenocutaneous fistula,and to study the methods of diagnosis and treatment.Mehtods:The occurrence causes,clinical manifestations and treatment were analysed retrospectively for 18 cases with high output duodenocutaneous fistula.Results:All of 18 cases with high output duodenocutaneous fistula were post-operative complication.The time for diagnosis after operation was from 2 to 14 days.All patients received medical therapy,such as fast?gostro-intestinal decompression?anti-infection etc.7cases closed spontaneously.8 cases were treated with operation,among them 6 cases were treated by early operation after the occurrence of fistula 5 cases were cured;2 cases were treated by late operation and healled after operation.1 cases died of electrolyte disturbance.2 cases died of multiple system organ failure.Conclusion:Operation is the main cause to lead to high output duodenocutaneous fistula.Conservation treatment is necessary for all patients with duodenocutaneous fistula before cureable operation.Early operation may be considered if the conservation treatment is not better effect. [