双套管持续冲洗低负压吸引治疗食管颈部吻合口瘘效果观察  

Clinical research of the treatment on cervical esophagus fistula with low negative pressure suction by double eaping pipe

作　　者：姚圣[1] 刘灿辉[1] 杨楠[1] 李忠东[1] 李德闽[1] 董国华[1] 

机构地区：[1]南京大学医学院附属金陵医院南京军区南京总医院心胸外科,210002

出　　处：《中国综合临床》2016年第3期251-254,共4页Clinical Medicine of China

摘　　要：目的探讨双套管持续冲洗低负压吸引在食管癌术后颈部吻合口瘘治疗中临床效果，寻找治疗食管癌术后颈部吻合口瘘的有效治疗手段。方法回顾性分析2004年9月至2015年9月在我院进行食管癌术后出现颈部吻合口瘘140例患者的临床资料，其中85例采用双套管持续冲洗低负压吸引为观察组，55例采用常规开放引流换药为对照组。比较两组患者住院时间、痊愈时间、换药次数、颈部出血发生率及随访半年吻合口狭窄发生率和病死率。结果观察组住院时间[（15．94±1．57）d]低于对照组[（23．64±2．36）d]，痊愈时间[（8．00±1．55）d]低于对照组[（15．64±2．08）d]，换药次数[（6．22±1．52）次]低于对照组[（27．56±3．58）次]，颈部出血发生率（1．18％）低于对照组（12．24％），两组比较差异均有统计学意义（P值分别为0．000、0．000、0．000、0．029）；随访半年的吻合口狭窄发生率，观察组为17．65％，对照组为23．64％，两组比较差异无统计学意义（P=0．387）。结论双套管持续冲洗低负压吸引治疗食管癌术后颈部吻合口瘘可以缩短瘘口愈合时间，缩短住院时间，减少换药次数，降低颈部出血发生率，且不增加吻合口狭窄的发生率，较传统的开放引流换药能取得更好的治疗效果。Objective to investigate the clinical effect of negative pressure suction by double caping pipe on cervical esophagus fistula after esophageal carcinoma surgery, and search for the effective treatment of cervical anastomotic fistula after esophageal carcinoma surgery. Methods The clinical data of 140 patients with cervical esophagus fistula after esophageal carcinoma surgery in Nanjing General Hospital of Nanjing Command from September 2004 to September 2015 were retrospective analyzed. Among them, 85 cases were treated with low negative pressure suction by double caping pipe as experimental group, 55 cases were treated with conventional drainage and dressing as the control group. The length of hospital stay, healing time, dressing frequency,neck bleeding risk, anastomotic stenosis and mortality rate between two groups were analyzed and compared. Results The length of hospital stay, the time of wound healing, the frequency of wound change dressing, the rate of neck bleeding in experimental group were （ 15.94± 1.57） d, （ 8. 00± 1.55） d, （ 6. 22±1.52） times, 1.18% respectively, significantly lower than that of control group（ （ 23.64±2. 36） d, （ 15.64±2. 08） d, （27. 56±3.58） times, 12. 24%;P= 0. 000,0. 000,0. 000,0. 029）. While the rate of anastomotic stenosis after half a year in experimental group was 17.65% ,lower than that of the control group（23.64%） ,the difference was no significant（P= 0. 387）. Conclusion The treatment on cervical esophagus fistula with low negative pressure suction by double caping pipe has superiorities on hospitalization and healing time, dressing frequency, neck bleeding risk, mortality, and does not increase the incidence of anastomotic stenosis, and it can achieve a better therapeutic effect compare with the conventional drainage and dressing.

关 键 词：食管癌 颈部吻合口瘘 双套管 

分 类 号：R735.1[医药卫生—肿瘤]