经鼻内引流治疗食管癌术后吻合口瘘伴胸腔或纵隔脓肿效果观察  

Efficacy observation of intranasal drainage for esophageal cancer anastomotic fistula with abscess in thoracic cavity or mediastinum

作　　者：彭胜祖[1] 王彬[1] 张凯 叶辉[1] 杨斌[1] Peng Shengzu;Wang Bin;Zhang Kai;Ye Hui;Yang Bin(Department of Thoracic Surgery,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院、中国医学科学院肿瘤医院山西医院、山西医科大学附属肿瘤医院胸外科,太原030013

出　　处：《肿瘤研究与临床》2024年第11期843-846,共4页Cancer Research and Clinic

基　　金：山西省科技厅自然科学研究面上项目(202303021221236)。

摘　　要：目的探讨经鼻内引流治疗食管癌术后吻合口瘘伴胸腔或纵隔脓肿的临床效果。方法回顾性病例队列研究。分析2017年1月至2022年12月山西省肿瘤医院收治的食管癌术后出现吻合口瘘伴胸腔或纵隔脓肿的32例患者临床资料, 其中15例采用传统胸腔闭式引流方法(传统治疗组), 17例采用经鼻内引流方法(经鼻内引流组)。比较两组患者的体温异常时间、抗生素使用时间、吻合口瘘愈合时间、住院时间和吻合口狭窄的发生率。结果两组患者年龄、性别、肿瘤分期、手术方式和瘘口长径比较, 差异均无统计学意义(均P>0.05)。经鼻内引流组的体温异常时间短于传统治疗组[(6.1±1.5)d比(9.1±1.9)d], 差异有统计学意义(t=5.02, P<0.001);经鼻内引流组的抗生素使用时间短于传统治疗组[(11.5±1.9)d比(14.2±2.7)d], 差异有统计学意义(t=3.30, P<0.001);经鼻内引流组的吻合口瘘愈合时间短于传统治疗组[(20±4)d比(24±6)d], 差异有统计学意义(t=2.32, P<0.05);经鼻内引流组的住院时间短于传统治疗组[(27±3)d比(36±7)d], 差异有统计学意义(t=5.20, P<0.001)。两组治疗后吻合口狭窄的发生率差异无统计学意义(P>0.05)。结论对于食管癌切除术后发生吻合口瘘伴胸腔或纵隔脓肿不易引流的患者, 经鼻内引流是一种简单有效的治疗方法。Objective:To investigate the clinical effect of intranasal drainage in treatment of anastomotic fistula accompanied with abscess in thoracic cavity or mediastinum after esophageal cancer surgery.Methods:A retrospective case cohort study was conducted.The clinical data of 32 patients with anastomotic fistula and abscess in thoracic cavity or mediastinum after esophageal cancer surgery in Shanxi Province Cancer Hospital from January 2017 to December 2022 were analyzed.Among them,15 cases were treated with traditional closed thoracic drainage(the traditional group),and 17 cases were treated with intranasal drainage(the intranasal drainage group).The time of abnormal body temperature,antibiotic usage time,anastomotic fistula healing time,hospitalization stay and the incidence of anastomotic stenosis were compared between the both groups.Results:There were no statistically significant differences in age,gender,tumor staging,surgical method,and fistula diameter between the 2 groups(all P>0.05).The time of abnormal body temperature in the intranasal drainage group was shorter than that in the traditional group[(6.1±1.5)d vs.(9.1±1.9)d],and the difference was statistically significant(t=5.02,P<0.001).The usage time of antibiotic in the intranasal drainage group was shorter than that in the traditional group[(11.5±1.9)d vs.(14.2±2.7)d],and the difference was statistically significant(t=3.30,P<0.001).Anastomotic fistula healing time in the intranasal drainage group was shorter than that in the traditional group[(20±4)d vs.(24±6)d],and the difference was statistically significant(t=2.32,P<0.05).The hospitalization stay in the intranasal drainage group was shorter than that in the traditional group[(27±3)d vs.(36±7)d],and the difference was statistically significant(t=5.20,P<0.001).There was no statistically significant difference in the incidence of anastomotic stenosis between the 2 groups after treatment(P>0.05).Conclusions:Intranasal drainage is a simple and effective treatment method for patients with anastomoti

关 键 词：食管肿瘤 吻合口瘘 胸腔脓肿 纵隔脓肿 内引流 

分 类 号：R735.1[医药卫生—肿瘤]