手术治疗食管自发性破裂的意义  

Significance of surgery in treatment of spontaneous rupture of esophagus

作　　者：韩丁培[1] 杭钧彪[1] 曹子昂[2] 任健[1] 车嘉铭[1] 陈中元[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院胸外科,上海200025 [2]上海交通大学医学院附属仁济医院胸外科,上海200127

出　　处：《上海交通大学学报（医学版）》2014年第12期1854-1857,共4页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的探讨总结手术治疗食管自发性破裂的经验。方法回顾性分析1993年1月—2012年12月共计21例食管自发性破裂病例资料,包括病因、症状、出现症状至开始治疗时间间隔、治疗方式、转归及住院时间等。结果患者中男17例,女4例;年龄32~82岁（平均年龄43岁）;出现症状至手术治疗时间间隔〈24 h有9例（42.8%）,〈48 h有6例（28.6%）,〉72 h有6例（28.6%）;所有患者均接受手术治疗。一期愈合率〈24 h为88.9%,〈48 h为66.7%,〉72 h为0。所有患者均康复出院,平均住院天数〈24 h为18.1 d,〈48 h为27.8 d,〉72 h为51.2 d。结论手术仍是治疗食管自发性破裂的最佳手段,发病至手术时间越短患者的预后越好,时间间隔已不再是手术与否的评判标准,只要明确诊断,任何时候均有手术机会。Objective To explore and summarize the experience of surgical treatment of spontaneous rupture of esophagus.Methods The data of 21 cases of spontaneous rupture of esophagus from January 1993 to December 2012 were retrospectively analyzed,including etiologies,symptoms,time interval between onset and treatment,treatment methods,prognosis,hospital stays,etc.Results There were 17 male patients and 4female patients.Their age was between 32 and 82 years old（average 43 years old）.There were 9（42.8%）,6（28.6%）,and 6（28.6%） cases whose time intervals between onset and treat were 〈24 h,〈48 h,and 〉72h,respectively.All patients underwent surgical treatment.The primary healing rates were 88.9%（〈24 h）,66.7%（〈48 h）,and 0（〉72 h）.All patients were discharged with recovery.The average hospital stays were18.1 d（〈24 h）,27.8 d（〈48 h）,and 51.2 d（〉72 h）.Conclusion Surgery was the best way to treat spontaneous rupture of esophagus.The less the time interval between onset and treatment would be with the better the prognosis.The time interval is no longer a judgment standard of surgery.The surgery is indicated if a clear diagnosis can be made.

关 键 词：食管 破裂 治疗 手术 

分 类 号：R655.4[医药卫生—外科学]