自发性食管破裂的诊断和外科治疗

Diagnosis and surgical treatment of spontaneous rupture of esophagus (reports of 22 cases)

目的 总结自发性食管破裂诊断和外科治疗的经验。方法 对我院1966年至1998年收治的22例自发性食管破裂病例的诊断、治疗、结果进行回顾性分析。结果 本组病例10例在48 h内确诊并手术,死亡率为20％(2/10),超过48h的12例,死亡率为41.7％(5/12)。行一期修补术的9例中有5例距发病超过24小时,成功3例。结论 早期诊断和选择合理术式进行治疗是提高本病疗效,降低死亡率的关键。24 h不是能否行一期修补术的时间界限。

Objective: To summarize the experiments of diagnosis and surgical treatment of spontaneous ruture of esophagus (Boeahavve Syndrome ) . Methods: To review and anylize the diagnosis 、 treatments and results of 22 patients of spontaneous rupture of esophagus treated in our hospital in the years 1996- 1998.Results:Early diagnosis and operation were performed on 10 cases ( < 48 h)of the group and the mortality rate was 20% (2/10) ,the other 12 cases treated lately, the mortality rate was 41.7% (5/12) .5 cases of the patients admitted primary repair after 24 h,3 were successful . Conclusion: Early diagnosis and appropriate surgical treatments are the key to increase the curative effect and reduce the mortality rate. 24 h is not the demarcation line to determine whether primary repair should be done. Primary repair is the first choice if the condition of horizontal tear and thoracic cauity permit.