Lundy Jonathan B, Fischer Josef E
United States Army Institute of Surgical Research, Fort Sam Houston, Texas.
Clin Colon Rectal Surg. 2010 Sep;23(3):133-41. doi: 10.1055/s-0030-1262980.
Evidence can be found throughout surgical history of how devastating an enterocutaneous fistula (ECF) can be for both patient and surgeon. From antiquity, this complication of abdominal surgery, malignancy, radiation, trauma, or inflammatory processes has been a significant challenge to surgeons due to high associated mortality and significant morbidity. An ECF causes dehydration, malnutrition, skin excoriation, and sepsis, and has profound psychological effects on the patient. Recent mortality rates of patients suffering an ECF approach 20%. The authors illustrate the history of management of patients with ECF and discuss advances in perioperative care including parasurgical care, nutrition, wound care, and the history of surgical techniques.
在整个外科手术史上都能找到证据，表明肠皮肤瘘（ECF）对患者和外科医生而言可能是多么具有破坏性。从古代起，这种腹部手术、恶性肿瘤、放疗、创伤或炎症过程引发的并发症，就因其高相关死亡率和严重发病率，一直是外科医生面临的重大挑战。肠皮肤瘘会导致脱水、营养不良、皮肤破损和败血症，对患者产生深远的心理影响。近期患有肠皮肤瘘患者的死亡率接近20%。作者阐述了肠皮肤瘘患者的治疗史，并讨论了围手术期护理的进展，包括辅助手术护理、营养、伤口护理以及手术技术的发展历程。
