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在家成功治疗的腹膜-皮肤瘘:一例病例报告及文献综述

Peritoneal-cutaneous fistula successfully treated at home: A case report and literature review.

作者信息

Kiedrowski Mirosław, Mokrosz Eliza

机构信息

Ewdomed Ewa Szulecka Foundation and Home Hospice, Konstancin-Jeziorna, Poland.

Clinical Department of Oncology and Hematology, Central Clinical Hospital of the Ministry of Interior in Warsaw, Warsaw, Poland.

出版信息

Open Med (Wars). 2020 Nov 14;15(1):1150-1152. doi: 10.1515/med-2020-0245. eCollection 2020.

Abstract

We present the first case of peritoneal-cutaneous fistula (PCF) within ovarian carcinoma neoplastic infiltrates located inside a large abdominal hernia in a home hospice patient with massive ascites. It is an instructive case featuring a rapid diagnosis and efficient treatment of the PCF at home. As the patient refused hospitalization, she had successful paracentesis performed at home. Subsequent hydrocolloid dressing application, diuretics, and oral protein supplementation were recommended. Our intervention led to PCF closure, improved quality of life, and deepened the trust between the patient and the home hospice team. Our case demonstrates that in some instances, PCF may be efficiently treated at home, which may require paracentesis, appropriate dressings, and identification of all factors affecting healing. It also provides further support for the safety of paracentesis in home settings.

摘要

我们报告了首例在家中临终关怀的大量腹水患者的大腹壁疝内卵巢癌肿瘤浸润灶出现腹膜皮肤瘘(PCF)的病例。这是一个具有指导意义的病例,在家中对PCF进行了快速诊断和有效治疗。由于患者拒绝住院,在家中成功进行了腹腔穿刺术。随后建议应用水胶体敷料、利尿剂和口服补充蛋白质。我们的干预措施使PCF闭合,提高了生活质量,并加深了患者与家庭临终关怀团队之间的信任。我们的病例表明,在某些情况下,PCF可在家中得到有效治疗,这可能需要腹腔穿刺术、合适的敷料以及识别所有影响愈合的因素。它还为在家中进行腹腔穿刺术的安全性提供了进一步的支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f0a/7718635/e73d6fbe8a8e/j_med-2020-0245-fig001.jpg

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