预防性引流在食管癌手术患者的应用  

Application of preventatively placing drainage tube near anastomotic stoma in patients undergoing esophagectomy

作　　者：徐建康[1] 田文泽[1] 陈其友[1] 郑翔翔[1] 赵铭[1] 

机构地区：[1]南京医科大学附属淮安第一医院胸外科,江苏省淮安市223300

出　　处：《江苏医药》2017年第4期250-252,共3页Jiangsu Medical Journal

摘　　要：目的观察预防性放置吻合口引流管在食管癌手术患者的应用效果。方法经左胸食管癌手术患者257例分为两组:对照组143例,术毕常规放置胸腔引流管;试验组114例,食管胃吻合口附近另外放置扁头硅胶引流管。比较两组吻合口瘘发生率及其相关指标。结果试验组和对照组吻合口瘘发生率相仿(7.0%vs.6.3%)(P>0.05);试验组吻合口瘘确诊时间、患者临床缓解时间、再次置管比例、吻合口瘘后胸管带管时间和瘘口愈合时间均少于对照组[(8.0±3.0)d vs.(12.6±3.1)d、(9.6±5.3)d vs.(21.4±8.9)d、1/8vs.7/9、(12.0±6.9)d vs.(34.5±19.7)d和(30.5±6.5)d vs.(62.4±30.9)d](P<0.05或P<0.01)。结论食管胃吻合术中吻合口附近预防性放置引流管能早期诊断吻合口瘘,缩短瘘口愈合时间。Objective To observe the application value of preventatively placing drainage tube near anastomotic stoma in the patients with esophageal carcinoma undergoing esophagectomy.Methods A total of 257 patients with esophageal carcinoma undergoing esophagectomy via left chest was divided into two groups of A（indwelled with a preventative drainage tube near anastomotic stoma and conventional thoracic drainage tube,114cases）and B（indwelled with thoracic drainage tube alone,143cases）.The incidence of anastomotic fistula and relevant indicators were compared between two groups.Results There was no significant difference in the incidence of anastomotic leakage between two groups（7.0% vs.6.3%）（P〉0.05）.The definite diagnosis time of anastomotic fistula,clinical remission time,incidence of extra thoracic drainage tube insertion,indwelling time of drainage tube of the patients with anastomotic fistula and anastomotic fistula healing time were less in group A than those in group B[（8.0±3.0）days vs.（12.6±3.1）days,（9.6±5.3）days vs.（21.4±8.9）days,1/8vs.7/9,（12.0±6.9）days vs.（34.5±19.7）days and（30.5±6.5）days vs.（62.4±30.9）days]（P〈0.05 or P〈0.01）.Conclusion Preventatively placing a drainage tube near anastomotic stoma is able to make earlier diagnose of anastomotic fistula and shorten fistula healing time in the patients with esophageal carcinoma undergoing esophagectomy.

关 键 词：胸腔引流 食管癌 吻合口瘘 

分 类 号：R378[医药卫生—病原生物学]