空肠移植重建咽食管肠咽吻合口并发症的处理  

The Management of Complications of the Jejunopharyngeal Anastomosis with Jejuna Graft

作　　者：孙耀昌[1] 陆书昌[2] 万国泰[1] 徐志飞[1] 

机构地区：[1]第二军医大学长征医院胸外科,200003 [2]第二军医大学长征医院耳鼻咽喉科,200003

出　　处：《中华胸心血管外科杂志》1995年第5期285-287,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：采用空肠移植重建食管治疗咽食管化学性烧伤后狭窄13例。其中4例术后发生肠咽吻合口并发症:1例因吻合口狭窄和喉部损伤严重,反复发生吸入性肺炎而于术后3周应用自体喉气管移植,成功地重建食管通道;3例吻合口高于喉上口者,发生咽下困难,均再次行吻合口成形术,术后恢复了吞咽或语言功能。During the past 13 years, 13 patients sufferring from hypopharyngeal and esophageal stenosis caused by chemical burns were admitted to our hospital. They were treated by jejunal graft for reconstruction of the esophagus. Four of 13 cases had postoperative complications from jejunopharyngeal anastomosis. In one patients being complicated with severe jejunopharyngeal anastomotic stenosis, heavy laryngeal injury and repeated aspiration pneumonoa, autolaryngo-tracheojejunal anastomosis was performed as the last resort for reconstruction of the food passage. Six months later, a successful laryngeal reconstruction was done to restore his epeech. The other 3 patients had dysphagia due to je-junopharyngostomy stoma above the level of laryngeal vestibule. Modified jejunopharyngostomy preformed 1- 6 months after the first operation relieved the dysphagia. All of these patients recovered well. These results demonstrate the feasibility of jejunopharyngostomy anastomosis for chemical burn involving the hypopharynx and large part of esophagus.

关 键 词：烧伤 食管 空肠移植 食管重建 肠咽吻合口 治疗 

分 类 号：R655.405[医药卫生—外科学] R655.406[医药卫生—临床医学]