摘要
目的探讨肠外瘘发生的原因和防治。方法分析我院近10年收治的43例结肠一期或二期吻合术病员的诊治情况、结肠吻合术后肠外瘘的原因及其防治。结果肠外瘘原因包括:1例是术前、术中诊断不明确,盲目行肠肿块切除、肠吻合术;1例在腹腔感染未得到有效的控制、肠管损伤严重水肿明显时强行做一期吻合,吻合的肠管无法愈合而致肠瘘;1例术前肠道准备不充分,肠道内有大量粪便、肠管水肿情况下强行做一期吻合。治疗或预防则根据以上原因进行。结论完善的术前准备及术中的正确操作,术后的水、电解质、酸碱平衡及恰当的营养,是结肠吻合口瘘的有效防治方法。
Objective To investigate the causes of enterocutaneous fistula related to colocolic anastomosis as well as its prevention and treatment. Methods The clinical data were collected and reviewed in 43 patients suffered from enterocutaneous fistula related to Stage Ⅰ or Ⅱ colocolic anastomosis in this hospital during recent 10 years, and an analysis was performed on their diagnosis and treatment and on causes of their enterocutaneous fistula after colocolie anastomosis and the corresponding prevention and treatment. Results The causes of enterocutaneous fistula related to colocolic anastomosis were as follows ： Intestinal tumor resection and anastomosis were performed in 1 case as the preoperative and intraoperative diagnosis was not clear. Operation was taken under apparent bowel edema as intra - abdominal infection had not been effectively controlled in 1 case with the result of unhealed intestinal fistula. Operation was taken under un - adequate preoperative bowel preparation with large amount of intestinal feces and intestinal edema, and fistula formed as anastomed intestine could not healed in 1 case. Prevention should be performed according to above causes. Condusion Sufficient preoperational preparation, proper and skilled surgical procedure during surgery, adequae balance of water, electrolytes and acid ＆ alkali as well as proper nutrition after operation are effective methods for treatment and prevention of enteroeutaneous fistula related to colocolic anastomosis.
出处
《临床和实验医学杂志》
2009年第8期93-94,共2页
Journal of Clinical and Experimental Medicine
关键词
肠外瘘
原因
预防治疗
Enterocutaneous fistula
Cause
Prevention
Treatment
