食管破裂26例临床分析

Diagnosis and Treatment of Esophagus Rupture

目的:总结了26例食管破裂的诊断和治疗经验,探讨食管破裂的诊断与治疗方法.方法:1988～2004年收治食管破裂患者26例,其中男25例,女1例,年龄28～72岁.26例患者中,2例保守治疗,6例切开食管摘取异物,3例行胸腔、纵隔引流加空肠及胃造瘘术,14例行食管修补术,1例行食管内带膜金属支架植入,二期再行食管切除食管胃吻合术.结果:26例患者中23例治愈,3例死亡,治愈率88.5%.结论:早期正确诊断具有重要意义,治疗方案应在对其损伤部位、损伤时间、纵隔感染的程度及患者的全身情况进行全面分析,综合考虑的基础上加以选择.

Objective:To study the methods for the diagnosis and treatment of esophagus rupture and summarize the experience. Methods:From 1988 to 2004, 26 patients (25 males and 1femal, aged fr om 28～72 years old) with esophagus rupture were treated. Among the 26 cases, 2 cases received conservative treatment; 6 cases' esophaguses were slit to extirpa te heterogeneous things; 3 cases received thorax and mediastinal conduction adde d gastrostomy or jejunostomy; 14 cases received esophagus hernioplasty; 1case wa s put the metallic bracket into esophagus and then received esophagus resection and esophagus -gastric anastomosis in the second period. Results: Among the 26 cases, 23 cases were cured, 3 cases died, the curing rate was 88 .5%. Conclusion:The correct diagnosis for early esophagus rup ture has important significance. The program for treatment should be selected on the bases of a thorough analysis and a comprehensive consideration for the inju red location, the time, the level of mediastinal infection and the whole situati on of patients.