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影响接受保守治疗的肠外瘘患者自愈因素的回顾性分析。

Retrospective analysis of factors influencing the self-healing of patients with enterocutaneous fistulas receiving conservative treatment.

作者信息

Zhuang Zhuo-Nan, Zhao Rui, Li Yuan-Xin

机构信息

Department of Gastrointestinal, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China.

Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China.

出版信息

World J Gastrointest Oncol. 2025 Mar 15;17(3):101076. doi: 10.4251/wjgo.v17.i3.101076.

Abstract

BACKGROUND

Enterocutaneous (EC) fistula incidence has been increasing in China, along with increases in the volume and complexity of surgeries. The conservative treatment strategy has been analyzed to improve the treatment outcomes for patients with EC fistulas and reduce the need for reoperation.

AIM

To analyze the clinical data of patients undergoing conservative treatment for EC fistulas and identify the factors that promote self-healing. These findings provide a reference for improving the clinical cure rate of EC fistulas with conservative treatment.

METHODS

The clinical data of 91 patients with EC fistulas who underwent conservative treatment were collected. The relationships between the cure rate and characteristics such as age, sex, body mass index, albumin level, primary disease, cause of the fistula, location of the fistula, number of fistulas, nature of the fistula, infection status, diagnostic methods, nutritional support methods, somatostatin therapy, growth hormone therapy, and fibrin glue therapy were analyzed.

RESULTS

A comparison of the basic patient characteristics between the two groups revealed statistically significant differences in primary disease ( = 0.044), location of the fistula ( = 0.006), number of fistulas ( = 0.007), and use of adhesive sealing ( = 12.194, < 0.001) between the uncured and cured groups. The use of fibrin glue was a significant factor associated with a cure for fistulas (odds ratio = 5.459, 95%CI: 1.958-15.219, = 0.01).

CONCLUSION

The cure rate of patients with a single EC fistula can be effectively improved conservative treatment combined with the use of biological fibrin glue to seal the fistula.

摘要

背景

随着手术量和复杂性的增加,中国肠外瘘(EC)的发病率一直在上升。已对保守治疗策略进行分析,以改善EC瘘患者的治疗效果并减少再次手术的需求。

目的

分析接受EC瘘保守治疗患者的临床资料,并确定促进自愈的因素。这些发现为提高保守治疗EC瘘的临床治愈率提供参考。

方法

收集91例接受保守治疗的EC瘘患者的临床资料。分析治愈率与年龄、性别、体重指数、白蛋白水平、原发疾病、瘘的病因、瘘的位置、瘘的数量、瘘的性质、感染状况、诊断方法、营养支持方法、生长抑素治疗、生长激素治疗和纤维蛋白胶治疗等特征之间的关系。

结果

两组患者基本特征比较显示,未治愈组和治愈组在原发疾病(P = 0.044)、瘘的位置(P = 0.006)、瘘的数量(P = 0.007)以及使用黏合封闭(χ² = 12.194,P < 0.001)方面存在统计学显著差异。使用纤维蛋白胶是与瘘治愈相关的一个重要因素(比值比 = 5.459,95%CI:1.958 - 15.219,P = 0.01)。

结论

采用保守治疗联合使用生物纤维蛋白胶封闭瘘口可有效提高单一EC瘘患者的治愈率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27b0/11866217/0f4c038d1b00/101076-g001.jpg

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