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朱浩.消化道瘘的诊疗进展[J].内科急危重症杂志,2026,32(1):7-13
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| DOI：10.11768/nkjwzzzz20260102 |
| 中文关键词: 消化道瘘 诊疗 消化内镜 |
| 英文关键词: |
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| 摘要点击次数: 60 |
| 全文下载次数: 63 |
| 中文摘要: |
| 摘要 消化道瘘（GIF）是消化系统疾病及相关操作常见且严重的并发症，因消化内容物流入异常通道引发感染、营养不良等问题，延长住院时间并增加死亡风险，近年其管理随临床需求升级更趋复杂。该病以术后瘘最为常见，诊断需结合影像学、内镜学及实验室检查综合判断。治疗遵循“控制感染 有效引流 营养支持 修复”主线，基础管理强调个体化营养干预与电解质平衡维护。如今，内镜治疗已成为核心策略，呈现多技术组合趋势，上消化道瘘可采用夹闭、支架与负压治疗等方案，VACStent等技术显著提升愈合率；外科治疗转向“预防+微创修复”，微创与机器人手术在降低瘘发生率、改善恢复方面优势明显。未来，机器人与AI驱动的精准外科、负压引流创新及组织工程技术将推动诊疗精细化，复杂病例需多学科协作管理，以实现个体化精准治疗。 |
| 英文摘要: |
| Abstract Gastrointestinal fistula (GIF) is a common and serious complication of digestive system diseases and related procedures. It occurs due to abnormal passage of digestive contents into an abnormal channel, leading to infections, malnutrition, prolonged hospital stays, and increased mortality risks. In recent years, its management has become more complex as clinical needs have evolved. This condition is most commonly seen after surgery. Diagnosis requires a comprehensive assessment combining imaging, endoscopy, and laboratory tests. Treatment follows the main line of "controlling infection-effective drainage-nutritional support-repair". Basic management emphasizes individualized nutritional intervention and maintenance of electrolyte balance. Nowadays, endoscopic treatment has become the core strategy, showing a trend of multi-technology combination. For upper gastrointestinal fistulas, treatments such as clamping, stenting, and negative pressure therapy can be used. Technologies like VACStent have significantly improved the healing rate. Surgical treatment shifts towards "prevention + minimally invasive repair", with advantages of minimally invasive and robotic surgeries in reducing the incidence of fistulas and improving recovery. In the future, robotic and AI-driven precision surgery, innovative negative pressure drainage, and tissue engineering technologies will promote the refinement of diagnosis and treatment. Complex cases require multidisciplinary collaboration for management to achieve individualized and precise treatment. |
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