肠内营养管留置时间对食管癌术后颈部吻合口狭窄与瘘的影响  

Effect of indwelling time of enteral nutrition tube on neck anastomotic stenosis and hernia after esophageal cancer operation

作　　者：叶贯超 张春敭[1] 宋亚男[1] 刘亚飞[1] 韩露[1] 董博 吴春莉 齐宇 赵松[1] Ye Guanchao;Zhang Chunyang;Song Yanan;Liu Yafei;Han Lu;Dong Bo;Wu Chunli;Qi Yu;Zhao Song(Thoracic Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000,China)

机构地区：[1]郑州大学第一附属医院胸外科,郑州450000

出　　处：《河南外科学杂志》2020年第3期23-27,共5页Henan Journal of Surgery

摘　　要：目的探讨肠内营养管留置时间对食管癌术后颈部吻合口狭窄与瘘的影响。方法选取2016-07-2018-12间在郑州大学第一附属医院接受食管癌Mc-keown术式的400例食管癌患者,单因素分析采用t检验或Fisher确切概率法,多因素分析采用Logistic回归模型,计量结果采用(x±s)表示。分析肠内营养管留置时间与吻合口狭窄和瘘的关系。结果术后营养管留置时间与吻合口瘘显著相关(P<0.05),营养管留置4周的患者优于留置1周的患者;营养管留置时间与吻合口狭窄无明显相关(P>0.05)。结论术后化疗、吻合口瘘、瘢痕体质可能是食管癌术后吻合口狭窄的高危因素,营养管留置时间与吻合口狭窄无明显相关。术后呛咳可能是引起吻合口瘘的高危因素,营养管留置时间与吻合口瘘显著相关。营养管留置4周较营养管留置1周能减少术后吻合口瘘的发生率。Objective To explore the effect of enteral nutrition tube indwelling time on cervical anastomotic stenosis and hernia after esophageal cancer operation.Methods Selected 400 patients with esophageal cancer in the first affiliated hospital of zhengzhou university who received mcc-keown operation from 2016-07 to 2018-12. the univariate analysis used t test or fisher exact probability method, the multivariate analysis used logistic regression model, and the measurement results were (x±s) expressed. The relationship between enteral nutrition tube retention time and anastomotic stricture and fistula was analyzed.Results postoperative nutritional tube retention time was significantly correlated with anastomotic fistula((P<0.05)). patients with 4 weeks of retention were better than those with nutritional tube retention for 1 week;nutritional tube retention time was not significantly correlated with anastomotic stenosis(P>0.05).Conclusion Postoperative chemotherapy, anastomotic fistula, and scar constitution may be high risk factors for anastomotic stenosis after esophageal cancer, and there was no significant correlation between nutrition tube retention time and anastomotic stenosis. Cough after operation may be a high risk factor of anastomotic fistula, the time of indwelling nutrition tube was significantly related to anastomotic fistula, and 4 weeks of indwelling nutrition tube could reduce the incidence of anastomotic fistula after operation compared with 1 week of indwelling nutrition tube.

关 键 词：食管癌 颈部机械吻合 肠内营养管 吻合口狭窄 吻合口瘘 

分 类 号：R619[医药卫生—外科学]