15例Ⅴ型食管闭锁诊治经验探讨  

Diagnosis and treatment for 15 cases of Ⅴ type esophageal atresia

作　　者：代江涛[1] 吴春[1] 李洪波[1] 李勇刚[1] 王刚[1] 雷洪波[1] 赵录[1] 

机构地区：[1]重庆医科大学附属儿童医院心胸外科儿童发育疾病研究省部共建教育部重点实验室儿科学重庆市重点实验室重庆市儿童发育重大疾病诊治与预防国际科技合作基地,重庆400014

出　　处：《重庆医科大学学报》2016年第3期271-273,325,共3页Journal of Chongqing Medical University

基　　金：重庆市卫计委面上资助项目(编号:2015MSXM032);国家临床重点专科建设资助项目(编号:国卫办医函[2013]544)

摘　　要：目的:探讨15例Ⅴ型食管闭锁的诊断及治疗经验。方法:对2000年1月至2015年11月于我院就诊的15例Ⅴ型食管闭锁的诊断及治疗进行回顾性分析。结果:15例Ⅴ型食管闭锁分别通过食管碘油造影、纤维支气管镜联合胃镜、胸部CT气管食管三维重建诊断。早期1例Ⅴ型食管闭锁病人直接结扎气管食管瘘后1月复发,再次行气管食管分别缝合好转。其余病人均行气管食管瘘切断后分别缝合痊愈,术后随访1年食管造影未见吻合口狭窄,进食正常,无反复呼吸道感染。结论:Ⅴ型食管闭锁需食管碘油造影、纤维支气管镜联合胃镜、胸部CT气管食管三维重建才能明确诊断,气道食管瘘切断缝合是治疗Ⅴ型食管闭锁的可靠方法,术后恢复效果满意。Objective： To probe the diagnosis and treatment of V type esophageal atresia. Methods： A total of 15 children（from Jan- uary 2000 to November 2015） with V type esophageal atresia were enrolled in this retrospective study. The diagnosis and treatment of V type esophageal atresia were analyzed. Results： All the 15 cases with V type esophageal atresia were diagnosed by iodine oil contrast examination of esophagus, fiberoptic bronehoscopy combined with gastroscope and three-dimensional CT reconstruction of trachea and esophagus. One patient of V type esophageal atresia underwent tracheo-esophageal fistula ligation directly and experienced recurrence at one month postoperation; the patient recovered after tracheo-esophageal fistula suture. All other 14 patients recovered by suturing after tracheo-esophageal fistula. All patients were followed up for one year without suffering from anastomosis orifice stenosis, gastroesophageal reflux and recurrent respiratory tract infection. Conclusion： V type esophageal atresia can be diagnosised definitely by iodine oil contrast examination of esophagus, fiberoptic bronchoscopy combined with gastroscope and three-dimensional CT recon- struction of trachea and esophagus. The tracheo-esophageal fistula cutting off and suturing is an effective treatment for V type esophageal atresia.

关 键 词：Ⅴ型食管闭锁 诊治 经验 

分 类 号：R726[医药卫生—儿科]