On the clinical treatment of intestinal fistula.docVIP

 PAGE \* MERGEFORMAT 8 On the clinical treatment of intestinal fistula [Abstract] refers to intestinal fistula between the intestines and other organs of the abdominal wall and between the intestine and not between the normal channel. Previous fistula due to the high mortality rate with surgery is considered a “disaster” of disease, nearly 30 With the depth of its research, changes in treatment strategies, nutritional support and the development of surgical techniques to other deaths from the previous 50% to 60% to 20% now. [Keywords:] Clinical treatment of intestinal fistula (A) the treatment of intestinal fistula and nutritional support Principles of treatment of intestinal fistula: ① control the infection, correct water and electrolyte imbalance, acid-base balance: ② nutritional support, ③ the local treatment of fistula, ④ surgery. 1. Fistula infection control early, there is intra-abdominal infections, infection control is a prerequisite for successful treatment. In the intestinal fistula depends mainly on the local effective surgical drainage of acute peritonitis in the clear after the laparotomy, clear the intestinal fluid, or abscess, drainage or intraperitoneal colostomy placed. For high intestinal fistula, as in the air show fistula created at the remote line, in order to facilitate further enteral nutrition therapy. Another major infection control measures is the application of systemic antibiotics can be According to the results of bacterial culture selection of effective antibiotics, the bacterial cultures, should select broad-spectrum second and third generation cephalosporins, gentamicin, amikacin and other aminoglycoside antibiotics and metronidazole, tinidazole, etc. anti-anaerobic drugs. 2. Correcting water, electrolyte imbalance, correcting acid-base balance of intestinal fistula, especially after the high flow fistula, the patient has a large number of extracellular fluid loss, intravenous access should be open