胃肠道术后肠瘘治疗及预后分析.docVIP

胃肠道术后肠瘘治疗及预后分析 　　[摘 要] 目的：分析胃肠道术后肠瘘不同治疗方式的预后，总结治疗体会。方法：整理2013年10月至2017年2月74例胃肠道术后肠瘘患者临床资料，对其肠瘘位置、肠瘘类型、治疗方法及预后情况进行回顾性分析，总结胃肠道术后肠瘘治疗方式及治疗时机的选择策略。结果：患者肠瘘位置以低位瘘为主，占52.70%，其肠瘘形状、肠瘘数量、肠瘘流量分别以管状瘘、单发瘘、高流量瘘为主；患者肠瘘均于胃肠道术后2～14 d内发生，平均发生时间为（7.84±2.21）d，其中56例（75.68%）患者肠瘘发生于术后7～9 d。早期手术组住院时间最短，其次为晚期手术组，保守治疗组住院时间最长，差异有统计学意义（P0.05）。结论：确定性手术治疗胃肠道术后肠瘘的安全性良好，且可明显缩短住院时间，应全面评估患者手术指证，适时开展确定性手术。 　　[关键词] 胃肠道手术；肠瘘；预后 　　中图分类号：R656.6 文献标识码：A 文章编号：2095-5200（2017）05-004-03 　　DOI：10.11876/mimt201705002 　　The treatment and prognosis on the intestinal fistula following gastrointestinal tract operation LUAN Xiang， YUAN Zhixiang. （Department of General Surgery，Chengyang People’s Hospital， Qingdao 266109， china） 　　[Abstract] Objective： The object of this study was to analyze the prognosis of different treatment on intestinal fistula following gastrointestinal tract operation and summarize the clinical experience. Methods： A total of 74 intestinal fistula clinical data between October 2013 and February were collected. The sites， types， treatment and prognosis of their intestinal fistula were retrospectively analyzed. Finally， the strategy on the treatment and its timing of intestinal fistula were summarized. Results： The low fistula accounted for the most in intestinal fistula site （52.70%）. The shape， number and flow intestinal fistula were respectively dominated by the tube-shaped， single fistula and high flow； the intestinal fistula of all patients were occurred 2～14 days after gastrointestinal tract operation and the average time point was （7.84±2.21）days， of which 56 （75.68%） were occurred 7～9 days after gastrointestinal tract operation. The duration of hospitalization of early operation group was the shortest， followed by late operation group while the conservative treatment group was the longest， and the difference was statistically significant （P0.05）. Conclusions： The definitive operative treatment is of higher security and shortens the length of hospitalization， which should be duly c