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目的通过总结三家医院收治的7例胃空肠结肠瘘患者，并结合文献报告说明本病的诊断标准及治疗方法，强调在手术前后营养支持治疗的重要性．方法本组7例患者均为男性，平均年龄32岁（21岁～45岁），原发病皆为十二指肠球部溃疡，都做过溃疡穿孔修补术和（或）胃大部切除术．发生胃空肠结肠瘘（GJCF）的时间从术后4mo～12a不等（平均52mo）主要症状是腹痛、腹泻、呕吐粪样物、伴明显消瘦．术前都经钡灌肠得到确诊．结果7例（除例5）经过手术前的TPN准备后行一期GJCF切除术，术后继续给予营养支持治疗（包括TPN到TEN过渡），治愈5例，死亡2例．其中一例在过度到自然饮食时突发上消化道大出血，抢救无效而死亡．另一例未用TPN术后发生瘘而死亡结论发生胃结肠瘘（GJCF）的常见原因为十二指肠球部溃疡行胃大部切除后发生吻合口溃疡并穿透结肠所致，多与高酸有关．诊断主要根据病史和手术史．钡灌肠检查是确诊此病的主要手段．在治疗中手术前后应用TPN改善患者的营养状况是保证手术成功的关键．
Objective To summarize the seven cases of gastrojejunostomy fistula admitted to three hospitals and to combine the literature reports with the diagnostic criteria and treatment methods of the disease to emphasize the importance of nutritional support before and after surgery. Methods The seven patients in this study were all male, with an average age of 32 years old (21 years old to 45 years old). All the primary diseases were duodenal ulcer. All of them had ulcer perforation repair and / or subtotal gastrectomy Surgery. The occurrence of gastrojejun jejunal fistula (GJCF) from 4mo ~ 12a postoperative range of 12 months (average 52mo) The main symptoms are abdominal pain, diarrhea, vomiting fecal samples, with significant weight loss. Barium enema were confirmed before surgery. Results Seven cases (except in case 5) underwent GJCF resection after preoperative TPN preparation. Nutritional supportive treatment (including transition from TPN to TEN) was continued after operation. Five cases were cured and two died. One case of excessive bleeding in the upper gastrointestinal tract over the natural diet died of ineffective rescue. Another case of death without the occurrence of fistula after TPN Conclusions The most common cause of gastrocolic fistula (GJCF) is the result of anastomotic ulceration and perforation of the colon following a radical gastrectomy of the duodenal bulb ulcer. Acid related. The diagnosis mainly based on history and surgery history. Barium enema examination is the main means of diagnosis of the disease. Applying TPN before and after surgery to improve the nutritional status of patients is the key to successful operation.