摘要
目的：探讨短肠综合征合并肠外瘘的临床特点与治疗方法。方法选择2008年1月至2015年12月普外科收治的剩余小肠＜105 cm 的肠外瘘患者36例，对其肠外瘘发生部位、原因、治疗方法和肠康复方法进行回顾性分析。结果36例中治愈23例，死亡4例，9例好转后中断治疗出院。患者肠管残存长度为（61.05±28.60）cm。31例接受肠内营养，其中10例未接受肠康复治疗，肠管长度为（53.30±31.60）cm，肠内营养恢复时间为（131.50±91.20）d；21例接受肠康复治疗，肠管长度为（63.60±20.50）cm，肠内营养恢复时间为（60.10±49.80）d。结论短肠综合征并肠外瘘的主要疾病为肠扭转、肠坏死，肠瘘部位多在吻合口，因肠坏死范围较广，手术切除界限不易判断。早期应用生长抑素能够减少消化液分泌的作用，同时能够减少短肠综合征急性期的腹泻及电解质紊乱症状。后期应用生长抑素能促进肠外瘘自愈和肠康复的双重作用。
Objective To investigate the clinical characteristics and treatment of short bowel syndrome（SBS）complicated with intestinal fistula. Methods The causes,locations,surgery therapy and intestinal rhabilitation therapy of intestinal fistula were retrospectively analyzed in collected enteric fistula patients with small bowel length less than 105 cm from January 2008 to December 2015. Results Twen-ty-three patients were treated successfully,four patients died and nine patients gave up treatment among the 36 enteric patients. The mean length of residual small bowel was（61. 05 ± 28. 60）cm. Enteral nutri-tion（EN）were restored in 31 patients,among whom ten patients with average residual small bowel length （53. 30 ± 31. 60）cm did not receive intestinal rehabilitation therapy and EN was restored in（131. 50 ± 91. 20）days;twenty-one patients with average residual small bowel length（63. 60 ± 20. 50）cm received intestinal rehabilitation therapy and EN was restored in（60. 10 ± 49. 80）days. Conclusions The main＆amp;nbsp;cause of enteric fistula is small intestine volvulus and fistula site located mianly at intestinal anastomosis. The main reason of enteric fistula is that necrotic margin can not be decided clearly. Early use of soma-tostatin can rduce gastrointestinal fluid and alleviate the symptoms of diarrhea. Subsequent use of soma-totropin can promote the spontaneous close of enteric fistula and the adaption of intestinal epithelium both in function and structure.
出处
《中国实用医刊》
2016年第24期43-45,共3页
Chinese Journal of Practical Medicine
关键词
短肠综合征
肠瘘
肠康复
肠内营养
Short bowel syndrome
Enteric fistula
Rehabilitative
Enteral nutrition
