自发性食管破裂12例诊治分析

Analysis of the Diagnosis and Treatment of Spontaneous Esophageal Ruptures in 12 Patients

【目的】总结自发性食管破裂的诊治经验。【方法】对12例自发性食管破裂的临床资料进行回顾性分析。【结果】9例得到正确的诊断,3例误诊为急腹症。行食管破裂切除食管胃吻合术8例,其中7例治愈,1例死亡,平均住院时间21 d;行修补术1例,术后d5因感染性休克死亡;行分流术3例,平均43.6 d治愈出院。【结论】剧烈呕吐(尤其是原有胃食管炎病史者),随后出现胸痛,应考虑本病可能;食管破裂切除食管胃吻合术是其有效的手术方式。

[Objective]To summarize the diagnosis and treatment of spontaneous esophageal ruptures. [Methods]The clinic data of 12 patients with spontaneous esophageal rupture were analyzed retrospectively. [Results] The right diagnosis was made in 9 patients ,but misdiagnosed as acute abdomen in 3 patients. Eight patients underwent esophagectomy and reconstruction by gastroesophageal anastomosis, 7 patients were cured , 1 patient died , the mean postoperative stay was 21 days.One case underwent repair and died on fifth postoperative day for septic shock. Bypass was done in 3 cases, the mean postoperative stay was 43. 6 days. [Conclusion]Spontaneous esophageal ruptures should be considered if patients show severe vomiting and then ehest pain. Resection of the ruptured segments and gastroesophageal anastomosis are the chief and efficient operative methods.