肠外瘘的诊断及外科治疗

目的　探讨肠外瘘的诊断及外科治疗 ,以提高治愈率 ,降低死亡率。方法　对 1981年 1月～ 1998年5月间收治的 5 1例肠外瘘的临床表现、治疗情况进行总结 ,并结合文献分析。结果　在 5 1例中 ,包括高位小肠瘘17例 (其中十二指肠瘘 7例 ) ,低位小肠瘘 2 6例 ,结肠瘘 8例。治愈 33例 ,治愈率 6 4.71% (33/ 5 1)。其中经保守治疗自愈 19例 (5 7.5 8% ) ,经手术治愈 14例 (4 2 .42 % ) ;死亡 11例 ,死亡率 2 1.5 7% (11/ 5 1)。结论　早期诊断 ,采取以及时彻底引流、控制感染、纠正内稳态失衡、合理营养支持为主要内容的综合个体化治疗是治疗成功的关键

Diagnosis and surgical treatment of external intestinal fistula

Objectives To elevate curative rate and to degrade mortality,the diagnosis and surgical treatment of external intestinal fistula were investigated.Methods The data of clinical manifestations and management of external intestinal fistula of 51 cases admitted to department of general surgery from january 1981 to May 1998 were analysed and the literatures were reviewed.Results of 51 cases,17 lesions were in upper intestine including 7 in duodenum,26 were in lower intestine,8 lied in colon.of 33 cases (64.71%) cured,14 patients (42.42%) underwent re-operation,19(57.58%) did not.11 patients (21.57%) died.Conclusions The key measures of successful cure include early diagnosis,timely thorough drainage,control of infection,redressing the balance of internal circumstances,suitable support of nutrition,and other individual comprehensive measures.