两种非开胸食管切除术有关出血的研究  

A Comparative Study of Blood Loss between Inversion Extraction and Transhiatal Blunt Dissection for Esophagectomy in Dogs

作　　者：聂坤荣 黄国俊[1] 张大为[1] 张汝刚[1] 汪良骏[1] 

机构地区：[1]中国医学科学院肿瘤医院胸外科

出　　处：《中华胸心血管外科杂志》1994年第1期73-75,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：４０只成年杂种犬随机分为两组，分别施行食管内翻剥脱和钝性分离拔脱术。通过术中左侧开胸直视观察，纱布称重计算纵隔出血量，术后胸主动脉铸型和尸检方法，研究两种术式食管动脉的损伤情况。结果发现：钝性分离术的平均纵隔出血量为９８±２０．５ｍｌ，比内翻剥脱术４５．４±１４．５ｍｌ多一倍（Ｐ＜０．００１）；前者主要损伤食管表面的动脉干部，而后者主要损伤其末梢。食管周围纵隔组织内食管动脉受损后自行收缩、凝血，是非开胸食管切除术出血量不过大的根本原因。y:This paper reports the results of a comparative study of blood loss and bleeding mechanism in 40dogs randomizedivided into Group A treated with inversion extraction and Group B with transhiatal blunt dissection all with a left thoracotomy for observation.The average blood loss from the esophageal bed as determined by gauze weighing method was 45.4+14.5 m' in Group A and 98.00+20.5 ml in Group B (P<0.001).Gross and microscopic examinations, as well as arterial castings all showed that the blood vessels supplying the esophagus were mostly torn at the fine terminals in Group A and a the trunks in Group B.This phenomenon probably explain the relatively limited blood loss in esophagectomy without thoracotomy and the significant difference in the amount of blood loss between its two different techniques.

关 键 词：非开胸 食管切除术 食管动脉 出血 

分 类 号：R655.4[医药卫生—外科学]