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目的 :探讨直肠癌保肛术后发生肠外瘘的非手术治疗方法。方法 :对 92例直肠癌保肛术后发生肠外瘘患者采用非手术综合方法治疗 ,主要措施包括 :确保骶前引流通畅有效 ;合理使用抗生素 ;根据不同病情采用进食、肠外营养、肠内营养以增强患者营养状况 ;避免不必要的肛门指检。结果 :84例治愈 ,1例改行Miles术 ,1例出现真菌性败血症而自动出院 (出院后 2个月经随访未死亡 ) ,6例行横结肠造瘘术。从瘘发生至瘘治愈拔管时间平均 17.6天 ,最短 5天 ,最长 43天。结论 :直肠癌保肛术后肠外瘘绝大部分可以用非手术治疗方法而治愈 ,行横结肠造瘘术指征应从严掌握
Objective: To explore the non-surgical treatment of extra-intestinal fistula after rectocelectomy for rectal cancer. Methods: 92 patients with rectal cancer who underwent sphincterotomy were treated with non-surgical comprehensive treatment. The main measures included: ensuring smooth and effective drainage before ankle; reasonable use of antibiotics; eating, parenteral nutrition, and enteral nutrition according to different conditions Nutrition to enhance the nutritional status of patients; avoid unnecessary anal tests. Results: Eighty-four patients were cured, one patient was transferred to Miles, one patient developed fungal septicemia and was automatically discharged from the hospital (not followed up after two months after discharge). Six patients underwent transverse colostomy. The time from the occurrence of hemorrhoids to hemorrhoids was 17.6 days on average, with a minimum of 5 days and a maximum of 43 days. Conclusion: Most of the extra-intestinal fistula after rectocelectomy for rectal cancer can be cured by non-surgical treatment. The indications for transverse colostomy should be strictly controlled.