Thomas R J, Rosalion A
Aust N Z J Surg. 1978 Oct;48(5):535-9. doi: 10.1111/j.1445-2197.1978.tb00039.x.
Malnutrition is common in patients with gastrointestinal tract fistula, and is an important cause of the high mortality seen with this surgical complication. A prospective review of three years' experience in the management of fistulae with parenteral nutrition was undertaken, and the results obtained were compared with those in a group of patients treated prior to the introduction of this form of therapy. The use of parenteral nutrition resulted in a reduction of the mortality from 63% to 23% in unselected cases. The mortality was zero where parenteral nutrition was used in patients under 65 years of age with non-malignant disease. With parenteral nutrition therapy, the fistulae in almost all cases closed spontaneously, in contrast with a high proportion requiring operation (20 in 38 cases) where parenteral nutrition was not used. It is concluded that all patients with significant gastrointestinal fistula should be given appropriate parenteral nutrition as their prime mode of therapy.
营养不良在胃肠道瘘患者中很常见，是这种手术并发症导致高死亡率的重要原因。我们对三年来采用肠外营养治疗瘘管的经验进行了前瞻性回顾，并将所得结果与在这种治疗方式引入之前治疗的一组患者的结果进行了比较。在未筛选的病例中，使用肠外营养使死亡率从63%降至23%。在65岁以下患有非恶性疾病的患者中使用肠外营养，死亡率为零。采用肠外营养治疗时，几乎所有病例的瘘管都能自行闭合，相比之下，在未使用肠外营养的情况下，有很大比例的患者需要手术（38例中有20例）。得出的结论是，所有患有严重胃肠道瘘的患者都应给予适当的肠外营养作为主要治疗方式。
