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消化瘘的管理

Management of digestive fistulas.

作者信息

Ysebaert D, Van Hee R, Hubens G, Vaneerdeweg W, Eyskens E

机构信息

Dept. of Surgery, University Hospital Antwerp, Belgium.

出版信息

Scand J Gastroenterol Suppl. 1994;207:42-4. doi: 10.3109/00365529409104194.

DOI:10.3109/00365529409104194
PMID:7701267
Abstract

BACKGROUND

The efficacy of total parenteral nutrition and somatostatin was assessed in reducing output and promoting spontaneous closure of postoperative digestive fistulas.

METHODS

In a consecutive series of 23 patients, closure was achieved in 83% of patients after a mean fistula duration of 11.0 +/- 7.9 days and a mean of 13.2 +/- 7.0 days of drug treatment, and without mortality.

RESULTS

A marked first-day effect (output drop > 50%) was noted in 60% of patients and had a good prognosis. Infection of the fistula markedly prolonged fistula closure time, but did not affect total outcome.

CONCLUSION

Somatostatin has been shown to be very useful in the conservative treatment of digestive fistulas because of its ability to reduce output significantly and to accelerate spontaneous closure.

摘要

背景

评估了全胃肠外营养和生长抑素在减少术后消化瘘的排出量及促进其自发闭合方面的疗效。

方法

在连续的23例患者系列中,瘘管平均持续时间为11.0±7.9天,平均药物治疗时间为13.2±7.0天,83%的患者实现了闭合,且无死亡病例。

结果

60%的患者在第一天有显著效果(排出量下降>50%),且预后良好。瘘管感染显著延长了瘘管闭合时间,但不影响总体结果。

结论

生长抑素已被证明在消化瘘的保守治疗中非常有用,因为它能够显著减少排出量并加速自发闭合。

相似文献

1
Management of digestive fistulas.消化瘘的管理
Scand J Gastroenterol Suppl. 1994;207:42-4. doi: 10.3109/00365529409104194.
2
Failure of somatostatin to accelerate closure of enterocutaneous fistulas in patients receiving total parenteral nutrition.生长抑素未能加速接受全胃肠外营养患者肠皮肤瘘的愈合。
Lancet. 1986 May 31;1(8492):1271. doi: 10.1016/s0140-6736(86)91406-6.
3
Somatostatin in the management of gastrointestinal fistulas. A multicenter trial.
Arch Surg. 1992 Jan;127(1):97-9; discussion 100. doi: 10.1001/archsurg.1992.01420010115018.
4
Gastrointestinal fistulas: pathology and prognosis.胃肠瘘:病理学与预后
Scand J Gastroenterol Suppl. 1994;207:39-41. doi: 10.3109/00365529409104193.
5
[Total parenteral nutrition and somatostatin in hypersecretory pancreatic and pancreatico-jejunal fistulas].[全胃肠外营养与生长抑素治疗胰腺及胰空肠高分泌瘘]
Minerva Chir. 1985 May 31;40(10):711-5.
6
[Use of somatostatin in the conservative treatment of external pancreatic fistula].生长抑素在胰外瘘保守治疗中的应用
Rev Esp Enferm Apar Dig. 1989 Sep;76(3):222-8.
7
Treatment of external gastrointestinal fistulas by a combination of total parenteral nutrition and somatostatin.全胃肠外营养与生长抑素联合治疗胃肠道外瘘
JPEN J Parenter Enteral Nutr. 1987 Sep-Oct;11(5):465-70. doi: 10.1177/0148607187011005465.
8
Treatment of enterocutaneous fistulas with TPN and somatostatin, compared with patients who received TPN only.与仅接受全胃肠外营养(TPN)的患者相比,采用TPN和生长抑素治疗肠皮肤瘘。
Br J Clin Pract. 1990 Dec;44(12):616-8.
9
[Somatostatin and/or total parenteral nutrition for the treatment of intestinal fistulas].[生长抑素和/或全胃肠外营养治疗肠瘘]
Rev Esp Enferm Dig. 1990 Dec;78(6):345-7.
10
Evaluation of the effectiveness of octreotide in the conservative treatment of postoperative enterocutaneous fistulas.奥曲肽在术后肠皮肤瘘保守治疗中的有效性评估。
Hepatogastroenterology. 2002 Jul-Aug;49(46):1010-2.

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Int J Surg Case Rep. 2023 Nov;112:109016. doi: 10.1016/j.ijscr.2023.109016. Epub 2023 Nov 4.
2
High-output fistula.高流量瘘
Clin Colon Rectal Surg. 2004 May;17(2):89-98. doi: 10.1055/s-2004-828655.
3
Biliogastric diversion for the management of high-output duodenal fistula: report of two cases and literature review.用于治疗高流量十二指肠瘘的胆胃转流术:两例报告及文献综述
J Gastrointest Surg. 2009 Feb;13(2):299-303. doi: 10.1007/s11605-008-0677-6. Epub 2008 Sep 30.
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Rectus abdominis muscle flap for high-output duodenal fistula: novel technique.腹直肌肌瓣治疗高流量十二指肠瘘:新技术
World J Surg. 2004 Feb;28(2):179-82. doi: 10.1007/s00268-003-7017-5. Epub 2004 Jan 20.
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Optimising the treatment of upper gastrointestinal fistulae.优化上消化道瘘的治疗
Gut. 2001 Dec;49 Suppl 4(Suppl 4):iv22-31. doi: 10.1136/gut.49.suppl_4.iv21.
6
The relevance of gastrointestinal fistulae in clinical practice: a review.胃肠道瘘在临床实践中的相关性:综述
Gut. 2001 Dec;49 Suppl 4(Suppl 4):iv2-10. doi: 10.1136/gut.49.suppl_4.iv2.
7
Role of somatostatin-14 and its analogues in the management of gastrointestinal fistulae: clinical data.生长抑素-14及其类似物在胃肠瘘管理中的作用:临床数据
Gut. 2001 Dec;49 Suppl 4(Suppl 4):iv11-21. doi: 10.1136/gut.49.suppl_4.iv11.