妇科腹腔镜术后发生肠管损伤的诊治研究.docVIP

妇科腹腔镜术后肠外瘘的诊治研究 刘毅 孙丽君 （遵义医学院附属医院 妇产科 中国贵州省遵义市563003） 摘要 目的 妇科腹腔镜术后肠外瘘发生率低、早期诊断和治疗困难，保持有效的引流为治疗的重要措施，本研究通过对我科收治的妇科腹腔镜术后肠外瘘治疗患者的临床资料分析，以求最佳的治疗方案。方法 统计我科自2010年2月至2012年12月收治的63例妇科腹腔镜术后并发肠外瘘患者的治疗效果，其中腹腔双套管引流+腹腔引流冲洗术治疗患者32例，乳胶管单腔引流术治疗患者31例。结果 腹腔双套管引流+腹腔引流冲洗术患者，31例瘘口自愈，1例瘘口未愈；乳胶管单腔引流术患者，12例瘘口自愈，19例漏口未愈，后行腹腔双套管引流+腹腔引流冲洗术后愈合，两组治疗效果存在统计学差异（P0.05）。结论 腹腔双套管引流+腹腔引流冲洗术治疗变被动引流为主动引流，引流更充分有效，防止腹腔内持续感染及脓毒血症性脑病的进一步发展，治疗效果明显优于传统的乳胶管单腔引流术。 关键词:妇科腹腔镜；肠外瘘；腹腔双套管引流； 乳胶管单腔引流 Diagnosis and treatment of enterocutaneous fistula after gynecological laparoscopic surgery LIU Yi SUN Li-Jun （Department of Obstetrics and Gynecology, affiliated hospital of Zunyi medical college, zunyi, GuiZhou Province , China, 563003） Abstract objective The low incidence of enterocutaneous fistula after gynecological laparoscopic surgery, early diagnosis and treatment difficulties. The important measures is maintaining effective drainage for the treatment. In order to best treatment options, through the analysis of our hospital gynecological laparoscopic postoperative enterocutaneous fistula treatment of patients with clinical data.method adding up the therapeutic effect of 63 patients were treated for enterocutaneous fistula after gynecological laparoscopic surgery in our department, from february 2010 to december 2012. 32 patients were treated by the celiac double casing drainage and the peritoneal drainage lavage, 31 patients were treated by the latex tube drainage of single lumen. Result In the patients were treated by the celiac double casing drainage and the peritoneal drainage lavage, 31 cases of fistula healing, one case of fistula nonhealing, In the patients patients were treated by the latex tube drainage of single lumen, 12 cases of fistula healing, 19 cases of fistula nonhealing, treatment effect significant difference exists（P0.05）.conclusion The celiac double casing drainage and the peritoneal drainage the lavage treatment becomes pass