13例食管破裂的外科治疗分析  

Therapeutic Effects of Surgical Operation for Esophageal Rupture:A Retrospective Analysis of 13 Cases

作　　者：唐柯[1] 姜建青[1] 俞永康[1] 杨列[1] 郑琇山[1] 梁瑜[1] 范啸文 官廷华 

机构地区：[1]成都军区总医院胸外科,成都610083

出　　处：《成都医学院学报》2015年第3期339-342,共4页Journal of Chengdu Medical College

摘　　要：目的探讨食管破裂的外科治疗方法及效果。方法选取成都军区总医院胸外科2005年6月至2014年12月收治的各类型食管破裂患者13例作为研究对象,所有患者均进行外科治疗,其中10例患者采用Ⅰ期修补修补术,1例采用Ⅰ期食管旷置,Ⅱ期消化道重建,1例经颈部切口行颈部及上纵膈脓肿切开引流,1例经颈部切口行颈部脓肿切开引流。观察手术时间、术中出血量、术后呼吸机辅助时间和术后并发症等,评价临床疗效。结果手术时间为（152.5±58.61）min（55-280min）,术中出血量为（242.5±152.6）mL（10-600mL）,术后呼吸机辅助时间为（5.25±1.09）h（3-7h）,术后患者生命体征平稳,无严重并发症发生。10例Ⅰ期修补术患者成功9例（90.00%）,1例发生术后瘘并死于呼吸功能衰竭;消化道重建及切开引流患者均治愈出院,总治愈率为92.31%（12/13）。结论综合患者整体情况选择合适的手术方式和细致的术中操作是治疗食管破裂的关键,并能取得较好的治疗效果。Objective To evaluate the therapeutic effects of surgical operation for esophageal rupture so as to provide treatment experiences.Methods From June 2005 to December 2014,13 patients were diagnosed with various types of esophageal rupture in our department.Among those patients,10 cases were treated by repair surgery in stageⅠ,1case was treated by esophageal exclusion surgery in stage Ⅰ and digestive tract reconstruction in stageⅡ,1case received surgical drainage of abscess in cervical region and superior mediastinum from the cervical incision,and 1case received surgical drainage of abscess in cervical region from the cervical incision.Results For all patients,a cure rate of 92.31%（12/13）was achieved by surgical operation.In terms of the 10 cases treated by repair surgery in stageⅠ,the cure rate was 90.00%,among which 1case with postoperative fistula was died of respiratory failure.The other 3cases were all cured after receiving digestive tract reconstruction or incision drainage.Conclusion The use of appropriate surgical treatment for esophageal rupture can achieve good results,the appropriate surgical approach according to the situation of patients and meticulous operation is the key to treatment.

关 键 词：食管破裂 外科治疗 Ⅰ期修补术 

分 类 号：R655.4[医药卫生—外科学]