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目的:评价采用3D打印技术制作的肠瘘支架对腹腔开放合并肠空气瘘（EAF）进行瘘口封堵治疗的效果。方法:本研究为一项描述性病例系列研究。纳入标准：（1）接受腹腔开放疗法；（2）合并EAF。排除标准：（1）有两个或两个以上瘘口；（2）远端梗阻；（3）肠管狭窄超过50%。根据上述标准，回顾性纳入东部战区总医院普通外科2019年6月至2020年1月期间收治的17例腹腔开放合并EAF患者。通过窦道造影、CT重建和手指探查方式评估瘘口大小、瘘口周围肠管直径和瘘口周围肠管角度，基于评估数据设计并制作3D打印肠瘘支架，经瘘口置入支架。观察指标包括：（1）支架置入成功率；（2）置入后肠内容物流出量；（3）可耐受运动时间；（4）接受肠瘘确定性手术时间；（5）恢复肠内营养时间。用n t检验比较支架置入前后肠内容物流出量以及可耐受运动时间，肠内容物流出量和可耐受运动时间变化的统计采用重复测量方差分析法。n 结果:17例腹腔开放合并EAF的患者中男性13例，女性4例。全部患者均成功实施肠瘘支架置入术，置入后2 d行消化道造影检查均提示消化道通畅、无梗阻；且支架成功保持在原位直至确定性手术。未发现行肠瘘确定性手术的患者出现支架置入相关不良反应。支架置入后肠液流出量始终保持在较低水平，17例患者肠液流出量从第1天的（702.7±198.9）ml/d降低至第7天的（45.8±22.4）ml/d，差异有统计学意义（n F=10.380，n P<0.001）。支架置入后患者离床时间、运动时间均持续增加，运动耐受时间从第1天的（9.1±3.8）min/d延长至第14天的（106.9±21.8）min/d，差异有统计学意义（n F=41.727，n P<0.001）。截止支架置入术后120 d，15例患者成功实施肠瘘确定性手术和腹壁重建术。恢复肠内营养时间为3（2，5）d，自支架置入至接受手术行瘘口修复时间为（87.2±17.6）d。2例患者因严重腹腔感染合并多器官衰竭而死亡。n 结论:3D打印肠瘘支架可减少EAF瘘口处肠内容物的流出，并可促进患者恢复肠内营养和康复锻炼。“,”Objective:To investigate the efficacy of fistula stent made by 3D printing technique in the treatment of enteroatmospheric fistula.Methods:A descriptive case series study was carried out. Inclusion criteria: (1) patients with open abdomen; (2) patients with enteroatmospheric fistula. Exclusion criteria: (1) patient with two or more fistulas; (2) distal obstruction; (3) bowel stenosis over 50%. According to above criteria, 17 EAF patients admitted to the General Surgery Department of Jinling Hospital from June 2019 to January 2020 were retrospectively included in study. Based on the intestinal radiography, CT reconstruction and finger exploration, the size of fistula, the diameter of the intestinal tube and the angle of the intestinal lumen around the fistula were assessed. The 3D printing fistula stent was designed and established based on estimated data, and then placed through the fistula. Outcome measurements: (1) success rate of stent implantation; (2) outflow of intestinal contents after implantation; (3) tolerated exercise time; (4) receiving definite operation time for intestinal fistula; (5) time to recovery of enteral nutrition. The n t-test was used to compare the outflow amount of intestinal content before and after the stent implantation and the tolerated exercise time. The changes of the outflow amount of intestinal content and tolerated exercise time were analyzed by repeated measurement ANOVA.n Results:Seventeen EAF patients with open abdomen included 13 males and 4 females. All the patients successfully received intestinal fistula stent implantation. Gastrointestinal angiography 2 days after implantation showed that the digestive tract was unobstructed, and the stent was successfully kept in place until definite surgery. No stent implantation-related adverse reactions were found in patients undergoing definite intestinal fistula surgery. The average outflow amount of intestinal fluid within 7 days after implantation decreased from (702.7±198.9) ml/d to on the first day after implantation (45.8±22.4) ml/d on the 7th day(n F=10.380, n P<0.001). The ambulatory time and exercise time of patients continued to increase after stent implantation. The average tolerated exercise time within 14 days after stent implantation increased from (9.1±3.8) min/d to (106.9±21.8) min/d (n F=41.727, n P<0.001). Within 120 days after stent implantation, 15 patients successfully underwent definite surgery for intestinal fistula and reconstruction of abdominal wall. Patients needed a median (IQR) of 3 (2, 5) days to recover enteral nutrition. The average time from stent placement to surgery was (87.2±17.6) days. Two patients died of severe abdominal infection with multiple organ failure.n Conclusion:3D printing fistula stent can significantly and the outflow of intestinal contents and the difficulty of nursing, and help to restore enteral nutrition and rehabilitation exercise as soon as possible in EAF patients with open abdomen.