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富血小板血浆联合冻干凝血酶粉治疗复杂性肠外瘘:一例报告

Platelet-rich plasma combined with lyophilizing thrombin powder for the treatment of complicated enterocutaneous fistula: a case report.

作者信息

He Chao, Liu Kui, Zhao Zhijie, Lai Zhihao, Qu Linlin

机构信息

Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.

出版信息

Front Surg. 2023 Oct 20;10:1252045. doi: 10.3389/fsurg.2023.1252045. eCollection 2023.

Abstract

BACKGROUND

Enterocutaneous fistula is one of the most challenging problems facing surgeons. In severe cases, a large amount of fluid loss can lead to problems such as water and electrolyte acid-base imbalance, malnutrition, infection, and organ dysfunction. Here we reported a case of platelet-rich plasma combined with lyophilizing thrombin powder for the treatment of complicated enterocutaneous fistula.

CASE PRESENTATION

A 48-year-old male, more than 2 years after the operation of abdominal trauma, the leakage of the fistula in the right upper abdominal wall was accompanied by fever for 3 days. The Contrast Fistulography and upper abdomen CT accurately depicted the entry of the meglumine diatrizoate into the small intestine through the small fistula. The patient had a large abdominal wall defect and severe intestinal adhesions. Reoperation may lead to more serious ECF. Therefore, we decided to seal the fistulas with PRP combined with lyophilizing thrombin powder.

CONCLUSIONS

The findings in this case report suggest that the combination of PRP and lyophilized thrombin powder holds promise as a viable approach for managing ECF in patients with chronic abdominal wall fistulas, as it appears to facilitate fistula closure, reduce healing time, and improve patient outcomes.

摘要

背景

肠外瘘是外科医生面临的最具挑战性的问题之一。在严重情况下,大量体液流失会导致水和电解质酸碱失衡、营养不良、感染及器官功能障碍等问题。在此,我们报告一例采用富血小板血浆联合冻干凝血酶粉治疗复杂性肠外瘘的病例。

病例介绍

一名48岁男性,腹部外伤手术后两年多,右上腹壁瘘口渗漏并伴有发热3天。瘘管造影和上腹部CT准确显示泛影葡胺通过小瘘口进入小肠。该患者腹壁缺损较大且肠粘连严重。再次手术可能导致更严重的肠外瘘。因此,我们决定用富血小板血浆联合冻干凝血酶粉封闭瘘口。

结论

本病例报告结果表明,富血小板血浆和冻干凝血酶粉联合应用有望成为治疗慢性腹壁瘘患者肠外瘘的可行方法,因为它似乎有助于瘘口闭合、缩短愈合时间并改善患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdeb/10623002/6f1f8544fcdc/fsurg-10-1252045-g001.jpg

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