Treatment of postoperative enterocutaneous fistulas by high-pressure vacuum with a normal oral diet
Treatment of postoperative enterocutaneous fistulas by high-pressure vacuum with a normal oral diet
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DOI：
10.1159/000082317
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发表时间：
2004-01-01
影响因子：
2.7
通讯作者：
Egito, EST
中科院分区：
文献类型：
--
作者：
Medeiros, AC;Aires-Neto, T;Egito, EST
背景/目的：肠外瘘与住院时间延长、高发病率/死亡率和住院费用增加相关。本研究旨在描述使用真空系统和正常的口服饮食来处理这个问题。方法：分析74例近期和明确的术后外瘘的连续患者。腹部影像学检查用于排除脓肿和远端梗阻。用Foley导管密封瘘管，连接到负压烧瓶，根据需要每天更换，持续5、10或15天。允许正常口服饮食。结果：无患者死亡。血清白蛋白和转铁蛋白在治疗结束时显着高于开始时的水平。中等和低输出量瘘管的结果最好（97%闭合）。48例（65%）瘘管在5天后闭合，16例（22%）在10天后闭合，4例（5%）在15天后闭合。6例（8%）患者治疗失败，随后接受手术。1例患者瘘口未闭合，输出量低。治疗费用为41.75美元/天，被认为具有成本效益。结论：负压吸引系统在治疗瘘管中显示出良好的效果。它包括简单，低成本，住院时间短，没有皮肤破裂，正常饮食，良好的营养和活动模式。版权所有（C）2004 S. Karger AG，巴塞尔。
Background/Aims: Enterocutaneous fistulas are associated with prolonged hospital stay, high morbidity/ mortality, and increased hospital costs. This study aims to describe the use of a vacuum system and normal oral diet in dealing with this problem. Methods: Seventy-four consecutive patients with recent and defined external postoperative fistulas were analyzed. Abdominal imaging was used to exclude abscess and distal obstruction. The fistula tract was sealed with Foley catheter, connected to a negative pressure flask, changed daily for 5, 10 or 15 days, as necessary. A normal oral diet was permitted. Results: No patient died. Serum albumin and transferrin showed significantly higher levels at the end of treatment than at the beginning. The moderate and low-output fistulas had the best results (97% closed). Forty-eight (65%) fistulas closed after 5 days, 16 (22%) after 10 days and 4 (5%) after 15 days. Treatment failed in 6 (8%) patients, who subsequently underwent surgery. The fistula did not close in 1 patient with a low output. The cost of the treatment was USD 41.75/ day and it was considered cost-effective. Conclusions: The vacuum system demonstrated good results in the treatment of fistulas. It included simplicity, low cost, short hospital stay, absence of skin breakdown, normal eating, good nutrition and activity patterns. Copyright (C) 2004 S. Karger AG, Basel.