数字减影血管造影机引导置管引流在治疗术后吻合口瘘中的应用  

Digital subtraction angiography-guided draining in the treatment of post-esophagogastrostomy fistula

作　　者：刁强[1] 马延[1] 袁富红[1] 申翼[2] 

机构地区：[1]南京军区南京总医院医学影像科,南京210002 [2]南京军区南京总医院心胸外科,南京210002

出　　处：《医学研究生学报》2011年第9期941-943,共3页Journal of Medical Postgraduates

摘　　要：目的既往经治疗食管胃吻合口瘘的各种方法均存在一定的不足之处,为进一步提高疗效,文中探讨数字减影血管造影机(digital subtraction angiography,DSA)引导下置管引流治疗食管胃吻合口瘘的应用价值。方法分析23例明确诊断为食管胃吻合口瘘患者的临床资料,对23例患者采用DSA引导下同时置入空肠营养管和瘘腔引流管,并保留胸腔引流管的方法,以充分引流瘘腔脓液;另以采用传统三管治疗法(胃肠减压管、空肠造瘘管、胸腔引流管)治疗吻合口瘘的16例患者为对照组,比较2组的临床疗效。结果 DSA引导下置管引流治疗食管胃吻合口瘘的方法,在快速稳定患者病情、缩短治愈时间等方面,明显好于传统三管治疗法。结论 DSA引导下置管引流可在治愈食管胃吻合口瘘上优势明显,避免患者再次手术,值得在临床广泛推广。Objective All the treatment methods for post-esophagogastrostomy fistula have their shortcomings.This study was to assess the value of digital subtraction angiography（DAS）-guided draining in the treatment of post-esophagogastrostomy fistula.Methods We retrospectively analyzed the clinical data of 23 patients with post-esophagogastrostomy,all treated with the DSA-guided jejunal nutrient tube and fistulous draining tube,with the intrathoracic draining tube retained to drain the pus completely.We compared the results with those of the controls（n = 16） treated by the traditional method of three-tube（jejunal nutrient tube,fistulous draining tube and intrathoracic draining tube） combination.Results DSA-guided draining showed significant superiority over the three-tube combination method in quickly stabilizing the patient′s condition and shortening the healing time.Conclusion DSA-guided draining has its obvious advantages of improving the prognosis of post-esophagogastrostomy and avoiding the second operation.

关 键 词：数字减影血管造影机 置管引流 吻合口瘘 

分 类 号：R454.1[医药卫生—治疗学]