十二指肠外瘘的处理及预后危险因素分析

目的探讨十二指肠外瘘形成的原因、处理措施及影响预后的危险性因素.方法对1993年10月至2003年10月本院收治的十二指肠外瘘32例临床资料进行回顾性分析.结果治愈27例,死亡5例.致死原因为失血性休克和多器官功能不全综合征(MODS).死亡主要发生在早、中期, 急性腹腔感染、脓毒血症和反复大出血是十二指肠瘘预后差的高危险因素.结论维持血流动力学稳定,控制感染,准确把握手术时机、选择正确的手术方式等早期综合处理是减少病死率的关键.

Treatment of duodenocutaneous fistula and analysis of risk factors affecting its prognosis

Objective To investigate the causes leading to duodenocutaneous fistula, the treatment and the risk factors affecting its prognosis. Methods Clinical data of 32 patients with duodenocutaneous fistula between October 1993 and October 2003 were collected and analyzed retrospectively. Results 27 patients were cured successfully, 3 died from acute hemorrhagic shock and 2 from multiple organ dysfunction syndrome. The patients with duodenocutaneous fistula died at the early and intermediate stage. Acute abdominal infection, septic complications and recurrent bleeding were the risk factors affecting its prognosis. Conclusion The important way to reduce its mortality was correct treatment at early stage, Such as sustaining a stable blood dynamics, infection-control, grasping the opportunity for operation and selecting a suitable operation.