中下段食管癌根治术后胸内吻合口瘘的治疗体会  

Experience of the treatment of intrathoracic anastomotic leakage after resection of the mid-low thoracic esophageal carcinoma

作　　者：施仁忠[1] 张亚锋[1] 夏晓明[1] 

机构地区：[1]上海市第六人民医院金山分院胸外科,上海201500

出　　处：《临床和实验医学杂志》2012年第9期682-683,共2页Journal of Clinical and Experimental Medicine

摘　　要：目的观察运用手术和保守方法治疗中下段食管癌根治术后胸内吻合口瘘的临床疗效。方法选取1995年1月至2011年12月食管癌根治术后胸内吻合口瘘患者43例,按照治疗方法不同分为手术组(22例)和保守组(21例)。观察两组的转归、ICU监护时间、发热持续时间、胃肠减压时间、胸腔闭式引流时间、平均住院时间和平均住院费用。结果手术组的治愈率、病死率分别为86.7%和5.3%,与保守组的77.9%和7.9%比较,差异无统计学意义(P>0.05)。手术组的ICU监护时间、发热持续时间、胃肠减压时间、胸腔闭式引流时间、平均住院时间和平均住院费用较保守组明显缩短或者降低,差异有统计学意义(P<0.05或<0.01)。结论对于中下段食管癌根治术后胸内吻合口瘘,一旦发现,建议手术治疗,对改善患者的症状和节省医疗费用具有重要意义。Objective To observe the comparison of the intrathoracic anastomotic leakage after resection of the mid-low thoracic esophageal carcinoma with surgical and conservative treatment.Methods Forty-three cases of intrathoracic anastomotic leakage after resection of the mid-low thoracic esophageal carcinoma from January 1995 to December 2011 were divided into operation groups（22 cases） and conservation group（21 cases）.The outcome,ICU monitoring time,duration of fever,gastrointestinal decompression time,thoracic drainage time,the average length of stay and average hospital costs were observed.Results The cure rate and mortality rate were 86.7% and 5.3% in operation group,respectively,77.9% and 7.9% in conservation group,the differences were not statistically significant（P0.05）.The ICU monitoring time,duration of fever,gastrointestinal decompression time,thoracic drainage time,average length of stay and average hospital charges were significantly reduced or lower in operation group compared with the conservation group,the differences were statistically significant（P0.05 or P0.01）.Conclusion Surgical treatment is recommended for patients with intrathoracic anastomotic leakage.It is helpful for improving the patient＇s symptoms and reducing medical costs.

关 键 词：食管癌 吻合口瘘 胸腔感染 治疗 预后 

分 类 号：R735.1[医药卫生—肿瘤]