食管裂孔疝两种手术入路的临床疗效比较  

Comparison of thoracic and transabdominal approches for the treatment of esophageal hiatal hernia

作　　者：张杨杨[1] 单龄童 浦祎玮 李王莺[3] 姚志坚[4] 葛文[5] 

机构地区：[1]同济大学附属东方医院心脏大血管外科,上海200120 [2]南京医科大学第-临床医学院,南京210029 [3]同济大学附属东方医院门诊部,上海200120 [4]山西医科大学上海东方临床医学院,上海200120 [5]上海中医药大学附属曙光医院胸心外科,上海201203

出　　处：《外科研究与新技术》2017年第3期165-168,共4页Surgical Research and New Technique

基　　金：上海市教委重点学科建设项目(J50307)

摘　　要：目的比较经胸入路与经腹入路手术治疗食管裂孔疝的安全性及有效性。方法需手术治疗的各类型食管裂孔疝患者18例,随机分为A组(10例经胸入路)和B组(8例经腹入路)。比较两组患者围手术期相关临床指标与近期随访情况。结果全组患者手术顺利,A组患者出现1例肺部感染,2例功能性胃瘫,经治疗得以恢复后出院。两组患者的手术时间、术后并发症发生率、术后引流量、术后住院时间、住院期间总费用等方面差异均无统计学意义。随访3个月主诉无明显不适,临床症状均得到有效缓解。结论两种手术入路治疗食管裂孔疝均能达到相同治疗效果,术后近期随访结果良好。Objective To compare the safety and effectiveness of thoracic approach and transabdominal approach for the treatment of esophageal hiatus hernia. Methods Eighteen patients with esophageal hiatal hernia who underwent surgical treatment were randomly divided into group A （10 cases with thoracic approach） and group B （8 cases with transabdominal approach）. The perioperative clinical indicators and short-term follow-ups of the two groups were compared. Results All the operations were successful. One case with pulmonary infection and two cases with functional gastroparesis in group A were recovered after treatment and discharged from hospital. There were no statisticallysignificant differences in operative time, incidence rate of postoperative complications, postoperative drainage, postoperative hospital stay,and total cost of hospitalization between group A and group B. After a 3-month follow-up, there was no obvious discomfort,and clinical symptoms were effectively relieved. Conclusion These two approaches for the treatment of esophageal hiatal hernia could achieve the same effect with good short-term prognosis.

关 键 词：食管裂孔疝 手术入路 临床疗效 

分 类 号：R655.4[医药卫生—外科学]