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目的:了解全国范围内肠内瘘的诊治情况，分析患者的临床特征及预后的影响因素。方法:采用多中心横断面研究方法，收集我国18家医疗中心2018年1月1日至12月31日收治住院的肠内瘘患者的临床资料，包括患者的基本信息、临床诊治资料及预后情况。结果:共纳入106例肠内瘘患者，男57例，女49例，年龄(48.0±17.8)岁。最常见的肠内瘘是肠膀胱瘘(36/106，34.0%)，随后是肠阴道瘘(34/106，31.1%)和肠肠内瘘(28/106，26.4%)，多发肠内瘘(9/106，8.5%)最少。恶性肿瘤(60/106，56.6%)是肠内瘘最常见的原发疾病，其次是克罗恩病(22/106，20.8%)。肠内瘘患者最常见的直接致瘘原因是外科手术(70/106，66.0%)，其次是克罗恩病(20/106，18.9%)和放射性肠损伤(12/106，11.3%)，还有4例患者致瘘原因不明。整个诊治病程中，95例患者接受了营养支持治疗，以肠内＋肠外营养支持(72/95，75.8%)为主。最终86例(81.1%)患者接受了手术治疗，手术治愈率为94.2%(81/86)，术后手术部位感染(SSI)发生率为8.1%(7/86)，术后再次肠瘘发生率为10.5%(9/86)。20例(18.9%)患者采用保守治疗的手段，自愈率为80.0%。患者总死亡率为8.5%(9/106)，其中肠阴道瘘患者死亡率最高为15.2%(5/33)。统计分析显示死亡组患者的年龄(n t＝－4.664，n P<0.001)、白细胞水平(n U＝663.000，n P＝0.010)、脓毒症(n P＝0.002)和多器官功能障碍综合征(MODS)(n P＝0.019)的发生率均高于治愈组。多因素分析提示高龄(n OR＝1.073，95% n CI：1.008～1.141，n P＝0.026)、并发脓毒症(n OR＝11.806，95% n CI：1.064～131.048，n P＝0.044)是肠内瘘患者死亡的独立危险因素。n 结论:肠内瘘的总体死亡率仍较高，恶性肿瘤是肠内瘘最常见的原发病。高龄和脓毒症是肠内瘘患者死亡的独立危险因素。“,”Objective:To investigate the diagnosis and treatment for intra-abdominal fistula in China, and to explore the prognostic factors.Methods:A multi-center cross-sectional study was conducted based on the Registration System of Chinese Gastrointestinal Fistula and Intra-Abdominal Infections to collect the clinical data of patients with intra-abdominal fistula from 18 medical centers from January 1, 2018 to December 31, 2018, including basic information, medical records and prognosis.Results:A total of 106 patients were enrolled in this study, including 57 males and 49 females, with an average age of (48.0±17.8)years. The most common type of intra-abdominal fistula was entero-vesical fistula (34.0%), followed by entero-vaginal fistula (31.1%), entero-enteric fistula (26.4%) and multiple fistula (8.5%). The direct causes of intra-abdominal fistula were mainly surgical operation (66.0%), followed by spontaneous fistula due to Crohn′s disease (18.9%), radiation intestinal injury (11.3%), and 4 cases (3.8%) of unknown reasons. During the whole treatment, 95 patients received nutritional support therapy, mainly EN+ PN (75.8%). Finally, 86 patients (81.1%) received surgical treatment, with a healing rate of 95.3%. After surgery, 8.1% of patients developed surgical site infections (SSI), and 10.5% had a relapse of fistula. 20 patients (18.9%) were treated conservatively, with a self-healing rate of 80.0%. The overall mortality rate was 8.5%, and the highest mortality (15.2%) was found in entero-enteric fistula. Statistical analysis showed that the age (n t=-4.664, n P<0.001), leucocyte level (n U=663.000, n P=0.010), sepsis (n P=0.002) and multiple organ dysfunction syndrome (MODS) (n P=0.019) were higher in the death group than those in the healing group. Multivariate analysis suggested that advanced age (n OR=1.073, 95% n CI: 1.008-1.141, n P=0.026) and complications of sepsis (n OR=11.806, 95% n CI: 1.064-131.048, n P=0.044) were independent risk factors of the death for patients with intra-abdominal fistula.n Conclusions:The overall mortality rate of intra-abdominal fistula is still high, and malignant tumor is the most common primary disease. Advanced age and sepsis are independent risk factors for death in patients with intra-abdominal fistula.