23例食管、贲门疾病术后胃内大出血分析  

Clinical analysis of bleeding in 23 patients after operation due to esophageal and cardiac diseases

作　　者：李军[1] 杨康[1] 王海东[1] 

机构地区：[1]第三军医大学西南医院胸心外科,重庆400038

出　　处：《重庆医学》2007年第24期2550-2550,2552,共2页Chongqing medicine

摘　　要：目的总结、分析食管、贲门疾病术后胃内大出血原因及诊疗方法。方法对食管癌切除术后20例,贲门癌术后2例及食管化学烧伤行结肠代食管术后1例,共计23例患者术后胃腔出血进行诊断,并结合,临床分别采取保守治疗和手术止血,观察疗效,总结分析诊治经验。结果经引流、体检、胸片及B超诊断为胃腔出血;16例经保守治疗成功;7例经保守治疗无效后立即开胸探查止血后6例顺利康复,1例术后6d因胃食管吻合口瘘导致严重右侧脓胸,1个月后衰竭死亡。结论食管、贲门疾病术后胃腔内出血易发生于器械处理的消化道断面上,一旦出血经保守治疗无效后应争取尽早再次手术止血,而对于出血的原因应从手术中多个方面积极预防。Objective To summarize the experience in the treatment of 23 patients with bleemng after operanon oue to esopnageal and cardiac diseases. Methods The 23 cases were performed operations in our department, including： esophageal carcinoma surgery in 20, cardiac cancer surgery in 2 and colon interposition because of esophageal burns in 1. We performed conservative treatment and surgury when they were found bleeding after operation. Results The diagnosis of the 23 cases was a gastric hemorrhage. Sixteen patients were recovered by conservative therapy, while 7 patients had to undergo operation to stop bleeding. And 6 of them, except 1 died a month later due to empyema induced by esophagograstric anastomotic fistulas, were recovered. Conclusion Bleeding after esophageal and cardiac diseases surgeries frequently happens at the digestive tract cross section processed by instrument, which should be avoided in operation. Once the conservative therapy is hard to stop the bleeding,surgery should be performed as early as possible.

关 键 词：食管贲门疾病 胃 大出血 

分 类 号：R735[医药卫生—肿瘤]