食管穿孔16例治疗体会

Treating Experience of 16 Cases with Esophageal Peforation

目的:探讨食管穿孔的诊断和治疗方法。方法:回顾性分析1996年-2004年收治的16例食管穿孔患者的临床资料,对其诊断和治疗方法进行总结。结果:术前经X线、胸腔穿刺、上消化道造影、胃镜及CT确诊。行食管Ⅰ期修补、颈部引流2例,行食管Ⅰ期修补、胸腔引流3例,胸腔引流、空肠造瘘4例,食管部分切除、食管胃吻合4例,放置食管支架2例,未手术1例。死亡6例(37.5%),发生并发症7例(43.8%)。结论:早期诊断、闭合瘘口、防止感染,是降低并发症,减少死亡率的根本措施。

Objective： To probe the diagnosis and treatment method of cases with esophageal perforation. Methods： The clinical materials of 16 cases of such patient from 1996 to 2004 were analyzed retrospectively in diagnosis and treatment. Results： The confirmed diagnosis before operation was obtained by X-ray, CT, thoracentesis, contrast examination of upper digestive tract and gastroscope. 2 cases were undergone primary esophageal neoplasty and neck drainage, 3 cases endured primary esophageal neoplasty and drainage of pleural cavity, 4 cases were operated with drainage of pleural cavity and jejunofistulaization, esophageal partial resection and esophagogastrostomy for 4 cases, placed esophageal stand for 2 cases and one patient free operation. 6 patients died after operation （37.5%）. 7 cases occurred complication （43.8%）. Conclusion： To diagnose early, close fistula and prevent infection might be the rational measure for reducing complications and decreasing mortality.