颈段食管穿孔29例诊治分析  

Analysis in diagnosis and treatment of 29 cases of cervical esophageal perforation

作　　者：刘海涛 罗庆[1] 张剑[1] 范立 曹佳星 Liu Haitao;Luo Qing;Zhang Jian;Fan Li;Cao Jiaxing(Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院耳鼻咽喉头颈外科,330006

出　　处：《中华耳鼻咽喉头颈外科杂志》2019年第8期610-613,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的分析总结异物致颈段食管穿孔的诊治体会.方法回顾2012年1月至2018年6月在南昌大学第一附属医院耳鼻咽喉头颈外科收治的异物致颈段食管穿孔患者29例,总结其治疗情况.结果异物致颈段食管穿孔共29例,其中28例均通过颈侧切开取出异物;另颈总动脉小穿孔大出血1例,行颈总动脉与食管瘘修补术,成功救治;所有患者均痊愈,恢复正常,成功出院.结论在诊断颈段食管穿孔时,术前颈部CT片定位非常重要,有呕血患者术前应完善颈部增强CT,颈侧切开取出可作为首选,寻找异物的过程中,炎症反应与手指的触诊可进一步协助定位异物.Objective To analyze and summarize the method and effect of cervical esophagus perforation. Methods A total of 29 cervical esophageal perforation patients caused by foreign body were retrospectively analyzed from January 2012 to June 2018 in Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Nanchang University. Results Among the 29 cervical esophageal perforation patients, 28 patients were extracted by lateral neck incision, 1 patient with carotid artery hemorrhea was rescued by repairing the fistula between carotid artery and esophage. All patients recovered and successfully discharged. There were no severe complications among all patients. Conclusions The cervical CT scan is important for diagnosing a cervical esophageal perforation. Enhancement CT scan is necessay for a patient with haematemesis. Lateral neck incision would be first choice for patients with big foreign bodies. Inflammatory reaction and finger palpation are helpful for locating foreign bodies.

关 键 词：异物 食管穿孔 诊断 治疗 

分 类 号：R653[医药卫生—外科学]