手术治疗9例获得性气管食管瘘  

Surgical management of 9 cases of pediatric acquired tracheoesophageal fistulas

作　　者：冯翠竹[1] 张艳霞[2] 李旭[2] 李响 李龙[2] Feng Cuizhu;Zhang Yanxia;Li Xu;Li Xiang;Li Long(Department of General Surgery,Children's Hospital Capital Institute of Pediatrics,Chinese Academy of Medical Science&Peking Union Medical College,Beijing 100020,China;Department of General Surgery,Children's Hospital,Capital Institute of Pediatrics,Beijing 100020,China)

机构地区：[1]首都儿科研究所附属儿童医院普通外科,北京协和医学院,中国医学科学院,北京100020 [2]首都儿科研究所附属儿童医院普通外科,北京100020

出　　处：《中华小儿外科杂志》2025年第3期203-207,共5页Chinese Journal of Pediatric Surgery

基　　金：首都儿科研究所课题(LCYJ-2025-06)。

摘　　要：目的探讨儿童获得性气管食管瘘的诊治策略与疗效。方法收集2010年9月至2023年4月首都儿科研究所附属儿童医院手术治疗的9例获得性气管食管瘘患儿的临床资料,其中男7例,女2例;入院年龄为(33±21)个月,范围在10~62个月;入院体重为(12±4)kg,范围在8~20 kg。致病原因包括误食纽扣电池或化学原料、颈部肿瘤手术。手术方法包括气管食管瘘修补术及结肠代食管术。结果患儿住院时间为(24±12)d,范围在14~50 d;手术时间为(177±100)min,范围在105~400 min,术后8例使用有创呼吸机支持,时间为(53±45)h,范围在20~144 h。2例食管吻合口漏,保守治疗后痊愈。术后随访1~12年,5例食管狭窄,分别行胃镜下球囊扩张1~12次后痊愈。无气管切开,无喉返神经损伤,无气管食管瘘复发。结论儿童获得性气管食管瘘在保守治疗无效的情况下手术治疗令人满意。Objective To explore the diagnostic and therapeutic strategies for pediatric acquired tracheoesophageal fistulas(aTEF).Methods Clinical data of 9 cases of pediatric aTEF who were surgically treated at Children's Hospital,Capital Institution of Pediatrics between September 2010 and April 2023 were retrospectively analyzed.There were 7 males and 2 females with a mean age of 33±21(10-62)months,and a body weight of 12±4(8-20)kg on admission.The causes of aTEF included button battery ingestion,chemical material ingestion,and neck tumor surgery.The surgical methods included tracheoesophageal fistula repair and colonic substitute esophagus.Results The mean length of stay was 24±12(14-50)days,and the operation time of 177±100(105-400)min.After surgery,8 children were supported by an invasive ventilator,with a mean duration of 53±45(20-144)h.Two cases reported esophageal anastomotic leakage,and cured after conservative treatment.Patients were followed up for 1-12 years.Five cases reported esophageal stricture,and were cured after 1-12 times gastroscopic balloon dilatation.No tracheotomy,no recurrent laryngeal nerve injury,and no recurrence of tracheoesophageal fistula were reported.Conclusions The effect of surgical treatment is satisfactory when conservative treatment fails in pediatric aTEF.

关 键 词：气管食管瘘 手术治疗 儿童 

分 类 号：R726.5[医药卫生—儿科]