持续封闭负压引流处理咽瘘的效果观察  

Effect of continuous sealing negative pressure drainage in the treatment of pharyngeal fistula

作　　者：王保为 侯晓智 夏明 许风雷 WANG Baowei;HOU Xiaozhi;XIA Ming;XU Fenglei(Department of Otolaryngology Head and Neck Surgery,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China)

机构地区：[1]山东第一医科大学附属省立医院耳鼻咽喉头颈外科,山东济南250021

出　　处：《中国耳鼻咽喉颅底外科杂志》2023年第2期26-30,共5页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的评估持续封闭负压引流处理咽瘘的效果。方法回顾性分析2019年6月—2021年11月于山东省立医院耳鼻咽喉头颈外科因喉癌、下咽癌、下咽癌合并食管癌、颈段食管癌行肿瘤切除并咽部直接吻合修补或使用组织瓣、管状胃、游离空肠等行咽部修复的患者117例,其中咽瘘者18例,咽瘘患者均用持续封闭负压引流方式处理咽瘘,分析其治疗过程及其术后疗效。结果18例咽瘘患者中,发现咽瘘时间为术后第4~26天,中位时间9 d;咽瘘持续时间为10~52 d,中位时间20 d。所有咽瘘患者咽瘘口均用持续封闭负压引流方式保守治疗愈合,均无需再行手术修补。结论持续封闭负压引流可减轻咽瘘患者痛苦、减少医师换药操作时间、缩短咽瘘持续时间,减少咽瘘发展至手术修补的几率。Objective To evaluate the effect of continuous sealing negative pressure drainage in the treatment of pharyngeal fistula.Methods A retrospective analysis was made on 117 patients who underwent tumor resection and repair of pharyngeal direct anastomosis or pharyngeal repair with tissue flap,tubular stomach or free jejunum in our department from June 2019 to Nov 2021.Of them,18 cases of pharyngeal fistula were included and treated with continuous sealing negative pressure drainage.The treatment process and postoperative efficacy were analyzed by descriptive statistics.Results Among the 18 patients with pharyngeal fistula,the time of pharyngeal fistula was found to be 4 to 26 days after operation(median time=9 days),and the duration of pharyngeal fistula was 10 to 52 days(median time=20 days).Pharyngeal fistula healed in all the patients with conservative management of continuous sealing negative pressure drainage without surgical repair.Conclusion Continuous sealing negative pressure drainage can alleviate patient’s suffering,reduce the dressing change operation time of doctors,shorten the duration of pharyngeal fistula,and reduce the probability of pharyngeal fistula developing to surgical repair.

关 键 词：咽喉癌 食管癌 咽瘘 持续封闭负压引流 

分 类 号：R739.6[医药卫生—肿瘤]