负压引流技术在食管癌术后颈部吻合口瘘中的运用  

The comparative analysis of two different treatment in cervical anastomotic Fistula after esophagectomy

作　　者：陈慧勇[1] 万仁平[1] 李友涛[1] 黄淼龙[1] 王林辉[1] CHENHui-yong WAN Ren-ping LIYou-tao HUANGMiao-long WANG Lin-hui(Department of Toracic Surgery, yuebei people＇s hospital in Guangdong province, Shaoguan 512026, China)

机构地区：[1]粤北人民医院胸外科,广东韶关512026

出　　处：《疾病监测与控制》2017年第9期692-692,688,共2页Journal of Diseases Monitor and Control

摘　　要：目的对比两种不同处理方式对食管癌术后吻合口瘘的疗效。方法回顾性分析我科2011年1月至2016年6月10月72例食管癌手术后颈部吻合口患者,2011-2013年38例颈部吻合口瘘均采用常规换药,自然愈合,愈合时间14~56天,平均时间22天。2014-2016年34例颈部吻合口瘘采取早期普理灵线缝合瘘口+颈部留置负压管引流,愈合时间9~30天,平均愈合时间15.88天。采用配对样本t检验对两种处理方式术后吻合口瘘愈合的时间进行对比分析。结果常规组:愈合时间14~56天,平均时间22.76天;实验组:愈合时间9~30天,平均愈合时间15.88天。两种不同颈部吻合口瘘处理方式在愈合时间上进行比较,t=5.378,P=0.002﹤0.05,两组在颈部吻合口愈合时间上差异有统计学意义。结论对于食管癌术后颈部吻合口瘘早期普理灵缝合加颈部负压引流可明显缩短愈合时间。Objective To compare the two different treament of the anastomotic fistula. Methods The date of 72 patients with cervical anastomotic fistula who accepted three-incison esophagectomy form January 2011 to October 2015 were retrospectively cellected. Among this,38 patients uderwent oepn wound dressing. The healing time range from 14 days to 56 days, average 22.76 days; The other 34 cases were taking early suture combining negative pressure drainage around the leak. The healing time range from 10 days to 30 days, average 15.88 days. The average healing time of anastomotic leakage were 22.76 vs 15.88, the were significant difference between the two groups P=0.002﹤0.05. Conclusion The early suture combining negative pressure drainage of the anastomotic leakage could reduce the healing time of the anastomotic leak, and it is worth popularize in clinic.

关 键 词：食管癌 颈部吻合口瘘 负压引流 

分 类 号：R735.1[医药卫生—肿瘤]