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目的探讨因结肠癌侵犯所致十二指肠结肠瘘的诊疗方法。方法收集笔者所在医院1990年1月至2011年12月22年间收治的7例结肠癌并发十二指肠结肠瘘患者的临床资料,对其手术处理方式及愈后情况进行分析。结果 7例均行手术治疗,其中6例肿瘤切除,术后临床症状及体征消失,存活8~39个月后死亡,平均存活时间15.3个月;另1例未能行肿瘤切除,术后37 d因营养不良及多脏器功能衰竭死亡。结论十二指肠结肠瘘为结肠癌晚期并发症,手术根治效果差,术后生存时间由原发肿瘤特性决定;合理选择手术方式可以有效缓解患者痛苦,提高其生存质量并延长生存期。
Objective To investigate the diagnosis and treatment of duodenal fistula caused by invasion of colon cancer. Methods The clinical data of 7 patients with colonic cancer complicated with duodenal fistula admitted from January 1990 to December 2011 in our hospital were collected and their surgical treatment and prognosis were analyzed. Results All the 7 cases underwent surgery. Among them, 6 cases were resected and the clinical symptoms and signs disappeared. The patients survived 8 to 39 months after operation and the mean survival time was 15.3 months. The other cases failed to undergo tumor resection and 37 d died of malnutrition and multiple organ failure. Conclusions Duodenal colonic fistula is a late complication of colon cancer. The curative effect of the operation is poor. The postoperative survival time is determined by the characteristics of the primary tumor. A reasonable choice of operation method can effectively relieve the patient’s suffering, improve the quality of life and prolong the survival period.