食管癌贲门癌术后胸腔积液的防治

Prevention and treatment of pleural effusion following resection of esophageal carcinoma and cardiac carcinoma

目的:探讨食管癌贲门癌术后胸腔积液的防治.方法与结果:从1989年1月1日～1996年12月31日,作者手术治疗食管癌贲门癌1951例,术后发生胸腔积液16例,发生率为0.82%.均经胸腔穿刺及闭式引流术治愈.结论:为预防食管癌贲门癌术后胸腔积液的发生:术中应细致操作,妥善处理食管床及淋巴结清扫创面,减少术后渗液;术中对侧纵隔胸膜破裂的病人,术末清除对侧胸腔积气积液,防止术后健侧胸腔积液;在食管重建术中,应用纵隔胃;保证通畅的胸腔闭式引流,促进肺的复张,并掌握好拔管的时机.

Objective:To study the prevention and treatment of pleural effusion after resection of esophageal carcinoma and cardiac carcinoma. Method and Result; From 1 Jan 1989 to 31 Dec 1996, 1951 cases of esophageal carcinoma and cardiac carci-noma were performed surgical treatment. 16 cases of them were complicated with pleural effusion postoperatively, its incidence was 0. 82%. All cases were cured by thoracentesis and closed thoracic drainage. Conclusions: Careful manipulation, ligating the surface of esophageal bed and clearance of lymphnodes could decrease the effusion after operation. Clearing the gas and effu-sion in the opposite pleura cavity could prevent the opposite pleural effusion. It is suggested to prevent the pleural effusion after resection of esophageal carcinoma and cardiac carcinoma by using the mediastinal stomach in the re-build of esophagus, keeping unobstructed closed thoracic drainage, promoting the espantion of lung, and mastering the time well to pull the drainage tube.