成人先天性食管支气管瘘的临床特点及外科治疗  

Clinical characteristics and curgical treatment of adult congenital bronchoesophageal fistula

作　　者：俞建琦[1] 张宝石[1] 刘颖[1] 郭楠楠[1] 李捷[1] 于长海[1] 

机构地区：[1]解放军总医院第一附属医院胸心外科,北京100048

出　　处：《胃肠病学和肝病学杂志》2010年第11期1012-1013,共2页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨成人先天性食管支气管瘘的临床特点,减少误诊、漏诊。方法回顾性分析6例患者成人先天性食管支气管瘘患者的临床特点及外科治疗方法。结果患者主要临床表现:咳嗽、咳痰(6/6),进流食呛咳(5/6)、咯血(4/6)、发热(3/6)、胸痛(1/6)。病史19～35年。入院前分别误诊为支气管扩张4例,肺脓肿1例,食管憩室1例。行食管造影(造影剂采用泛影葡胺)后,均证实食管支气管瘘。6例均行患侧下肺切除术,同时切除瘘管,食管瘘口两层缝合,并用胸膜、心包等包埋瘘口残端。5例术后痊愈出院,无复发。1例术后复发食管瘘,经再次手术后治愈。结论成人先天性食管支气管瘘的临床表现无特异性,但发病率低、病史长、误诊率高、术中粘连重、出血多、瘘口处理不当易复发为其共有的临床特点。Objective To explore the clinical characteristics of adult congenital bronchoesophageal fistula. Meth ods Clinical data of 6 adult congenital bronchoesophageal fistulas patients from May 1999 to Dec 2009 were reviewed retrospectively. Results Chief clinical manifestations of 6 cases were cough and expectoration （6/6） ,bucking after eating liquid food （5/6） ,hemoptysis （4/6） ,fever （3 /6） ,chest pain （1/6） . The medical history continued from 19 to 35 years. Four cases were diagnosised as bronchiectasis,1 case as lung abscess,1 case as esophageal diverticulum before final diagnosis. All bronchoesophageal fistulas were confirmed by esophagogram. Six cases were all treated with affected side lower lobectomy and removed of fistulas. Five cases fully recovered and 1 case recurred after operation. Conclusion The clinical characteristics of adult congenital bronchoesophageal have no specificity but have lower incidence rate,longer medical history and higher mistake diagnostic rate. It is easy to recur if fistula has not been removed of thoroughly.

关 键 词：食管支气管瘘 先天性 外科治疗 

分 类 号：R571[医药卫生—消化系统]