| Objective To evaluate the effects and advantage of using the double catheter negative pressure drainage via the seldinger technique for the treament of enteroc utaneous fistula.Method retrospective analysis the results of 21 cases of enterocutaneous fistula that all receive the double catheter negative pressure drainage via the seldinger t echnique for the treatment in our clinical department between 2011 and 2015.9 c ases of gastric malignancy,6 cases of colorectal malignant tumor,2 cases of pan creatic malignancy,1 case of multiple adenomatous polyposis of colon,1 case of hepatocellular carcinoma,1 case of lower common bile duct,1 case of gastric cancer complicated with colorectal cancer.Analysis Self-healing rate,number of d ays of hospitalization,catheter days,catheterization before and after 0-72 h maxim um temperature changes(armpit),catheter before and after 0-72 h Leukocyte and neutrophil percentage change.Results(1)Through the treatment,14 of the 21 patients were self cured,self h ealing rate is 66.67%,2 cases ware Automatic discharge,and the remaing 5 were recepted reoperation.The average length of hospital stay was(43.14±14.97d)and t ime of double catheter stay in body was(17.67±9.32d).(2)Before and after catheterization 0-72 h patients with the highest temperature changes: according to the degree of fever changes in the patients were divided into low fever and high fever group.Group A is set to double by seldinger drainage before 0-72 h temper ature changes at 36-37.2 ?,an average of(36.96 ± 0.28 ?),a total of seven c ases.Group B is set to double by seldinger sleeve before 0-72 h temperature chan ges at 37.3-38.5 ?,an average of(37.84 ± 0.41 ?),a total of 14 cases.Group A before and after puncture 0-72 h the highest body temperature,P <0.05,the d ifference has statistically significant.Group B before and after puncture 0-72 h the highest body temperature,P <0.05,the difference has statistically significance.To tal(Group A + Group B)compared to previous puncture and 0-72 h highest temp erature after the puncture,P <0.01,significant difference has statistically significa nt.(3)The changes of white blood cells and neutrophils after 0-72 h before and after catheterization:Of which the first five patients catheter leukocytes(WBC)an d neutrophil cell percentage(NEUT%)in the normal range,denoted ? group,WBC and neutrophil percentage increased a total of 16 cases recorded as ? gro up.? group before catheter WBC average of(6.72 ± 0.37)× 109 Ge / L,after drainage the average of WBC is of(6.98 ± 0.55)× 109 Ge / L,between the two,P <0.05,no statistical significance.? group before catheter WBC average of(12.54 ± 3.93)× 109 / L,after drainage,the average of WBC is of(9.23 ± 3.52)× 109 / L,between the two,P < 0.01,the difference has statistically significance.? Group catheter before NEUT% with an average of(68.1 ± 4.99)%,rear tube NEUT% with an average of(65.16±5.93)%,between the two,P > 0.05,no Statistical significance.? Group catheter before NEUT% with a n average of(83.69±1.41)%,after drainage,the average of WBC is of(78.40±6.12)%× 109 / L,between the two,P <0.05,the difference has Statistical si gnificance.Conclusion using the seldinger techniue in the catheterization of the double caht heter with negative pressure drainage is relatively secure in the treatment of the interstinal fistula,alos reduces the risk of catheterization effectively and enhances the accuracy of catheterization.It is significant to reduce the infection,control t he hemorrhage and inprove the treatment of the digestiva tract fistula. |
PDF Full Text Request