临床小儿外科杂志2018，Vol.17Issue(4)：274-277,281,5.DOI:10.3969/j.issn.1671-6353.2018.04.008
经阑尾残端置管造瘘在小儿一期末段回肠切除术中的应用研究
Application of indwelling catheter through appendix stump fistula in one-stage terminal ileectomy
黄圣余 1谢承 1林立华 1傅俊杰 1张通福1
作者信息
- 1. 福建省福州儿童医院普外科 福建省福州市,350000
- 折叠
摘要
Abstract
Objective To explore the safety and practicality of applying indwelling catheter through appendix stump fistula in one-stage terminal ileectomy.Methods Retrospective analyses were conducted for 38 children hospitalized with terminal ileum diseases from January 2007 to December 2016.After emergency or subemergency laparotomy,one-stage terminal ileum excision and anastomosis were performed.And anastomotic stoma was less than 10 cm away from ileocecus.And indwelling silica gel tube was guided through appendix stump fistula into proximal anastomosis.Results All operations were successful.The cases of terminal ileum atresia or terminal ileum stenosis in meconium ileus had anus exhaust at Days 8 and 6.In other cases,postoperative bowel function recovered at Days 3-4.All of them defecated after removing gastric tube and resumed a liquid diet after anus exhaust.And had semi-liquid diet without abdominal distention and vomiting after 1-2 days.After no ultrasonic evidence of liquid or seroperitoneum,drainage tube in right iliac fossa elicit was removed at Days 4-5.The incisions healed well at Days 7-14.The average duration of hospitalization was 9 days.Both diet and urine were normal without defecation in fistula at Days 2-5 after discharge.And fistula self-healed at Days 2-3.During outpatient followups for 6 months to 2 years,there was no occurrence of such complications as anastomotic fistula,anastomotic stricture,peritonitis,intestinal adhesion or volvulus.Conclusion One-stage terminal ileum excision and anastomosis are successful.It can effectively avoid anastomotic leak and retain physiological function of ileocecus.Yet it has no effect upon the growth,digestion and absorption of children.It's worthy of wider clinical application.关键词
末段回肠/吻合口漏/回盲瓣/阑尾造瘘/儿童Key words
Terminal ileum/Stomal leak/ileocecal valve/Appendix stump fistula/Child引用本文复制引用
黄圣余,谢承,林立华,傅俊杰,张通福..经阑尾残端置管造瘘在小儿一期末段回肠切除术中的应用研究[J].临床小儿外科杂志,2018,17(4):274-277,281,5.
