A modified abstructingpressing therapy done on 14 patients with high or low external intestinal fistulas following postoperative infection after abdominal operations was reported. The results showed that high or low external intestinal fistulas could be cured by the combined method of obstruction and compression. This therapy decreased the mortality rate, saved the patients from the risk period and shortened curing course of treatment. Finally the characteristics, the surgical procedure, precautions and advantages of the method were disscussed.
目的 探讨肠外瘘并腹腔感染的诊治。方法 回顾性分析我院2002年1月至2007年12月期间收治的86例肠外瘘并腹腔感染患者的临床资料。结果 所有肠瘘多在术后1~2周发生，经口服或引流管注入60%泛影葡胺60～100 ml造影后明确诊断，均行腹腔引流液细菌培养，加强抗感染。20例患者行腹腔冲洗引流，62例在B型超声定位下穿刺引流，4例急诊行剖腹冲洗引流，其中2例行降结肠造瘘。2例合并糖尿病的患者因全身感染严重且反复发作，出现多器官功能衰竭，分别于术后第15 天和第28 天死亡。其余84例住院治疗时间平均12 d，均顺利出院。结论 对肠外瘘并腹腔感染的患者，早期彻底的腹腔冲洗及有效的腹腔和脓肿引流，是控制感染、治愈肠外瘘的关键。
ObjectiveThe aim of this paper is to summarize the advantages and disadvantages of non-surgical treatments of the enterocutaneous fistula, in order to give some advice.MethodsPubmed, EMBASE, Medline, CNKI, and Wanfang databases were retrieved for the published article addressing the non-surgical treatments of enterocutaneous fistula between 2004 to 2018. The keywords were " enterocutaneous fistula” in English and Chinese, respectively. The non-surgical treatments of enterocutaneous fistula were reviewed.ResultsThe results of this search suggested that non-surgical treatments of the enterocutaneous fistula mainly include fibrin glue, endoscopic treatment, laser ablation, and somatostatin. Fibrin glue was widely used at domestic and abroad, but it needed repeated operations. Endoscopic treatment of enterocutaneous fistula required a certain professional foundation; laser ablation technology was still immature and required theoretical data support. Now, the use of somatostatin was controversial.ConclusionEach of measures have its advantages and disadvantages, we should determine according to the patient’s condition and economic situation.