食管胃吻合口瘘“防治路径”的临床评价  

Clinical assessment of procedural prevention and treatment to esophagogastric anastomotic leakage after esophagectomy

作　　者：周新涛[1] 刘建[1] 杜少鸣[1] 詹必成[1] 

机构地区：[1]安庆市立医院胸心外科,安徽安庆246003

出　　处：《皖南医学院学报》2014年第3期246-248,共3页Journal of Wannan Medical College

摘　　要：目的：针对食管胃吻合口瘘制订临床防治路径,比较入路径与非入路径患者的临床疗效,评价＂防治路径＂的临床应用价值。方法：2012年1月-2013年6月,安庆市立医院制订＂食管胃吻合口瘘防治路径＂,选取可左胸入路行食管癌根治手术的患者,按随机原则分为对照组与试验组,比较两组患者吻合口瘘发生率、瘘治愈率、住院天数、治愈时间、平均费用等方面的差别。结果：按＂防治路径＂处理患者,吻合口瘘发生率轻度降低,吻合口瘘愈合率略有提高,瘘患者住院天数、治愈时间较对照组明显缩短,平均费用低于对照组,随访2-36月,无吻合口瘘复发。结论：＂防治路径＂对降低吻合口瘘发生、治疗吻合口瘘有一定临床价值;对缩短平均住院日及治疗时间、降低治疗费用有积极的临床意义。Objective： To assess the clinical outcomes by applying procedural prevention and treatment strategies to precautionary management of esophagogastric anastomotic leakage after esophagectomy. Methods： A total of 122 patients undergone radical treatment of esophageal carcinoma via left thorax approach,between January 2012 and June 2013 in Anqing Municipal Hospital,were randomized into control group and experimental group on procedural prevention and treatment strategies basis. The two groups were compared pertaining to the incidence of anastomotic leak and its curative rate,length of stay in hospital,healing time and mean medical costs. Results： Reduced anastomotic leakage incidence,improved curative rate for the leakage,shortened hospital stay and early fistula healing as well as lowered medical costs were found in patients managed on procedural prevention and treatment strategy basis as compared with the controls. Follow-up in a period of 2 to 36 months showed no recurrence of anastomotic fistula. Conclusion： Procedural prevention and treatment strategy can be of clinical value in reducing the incidence of anastomotic leakage and of positive significance in shortening the length of hospital stay and therapy as well as bringing down the medical costs for such patients.

关 键 词：防治路径 食管癌 吻合口瘘 

分 类 号：R735.1[医药卫生—肿瘤]