食管癌患者手术后死亡病例回顾和原因分析

Review and Analysis of the Cause of Death after the Operation of Esophageal Carcinoma

目的:进一步明确食管癌患者手术死亡率,探讨不同时期食管癌手术死亡的主要原因。方法:回顾性分析我院自1954年1月开展食管外科至2003年12月50年间经外科成功切除食管癌手术2572例。按年代作统计,将前32年(1954年1月～1985年12月)和后18年(1986年1月～2003年12月)分为A、B两组,并就其术后死亡116例原因进行探讨分析。结果:A组手术死亡44例,死亡率为8.15%(44/540)。B组手术死亡72例,死亡率为3.54%(72/2032)。A、B两组死亡原因分析差异不大,最常见的死亡原因是吻合口瘘,其次是呼吸衰竭和呼吸循环衰竭;再次是心肌梗塞。结论:吻合口瘘、呼吸衰竭、呼吸循环衰竭、心血管病变(心肌梗塞心脏骤停)是本组食管癌术后死亡的主要原因。

To further clarify the operation mortality of esophageal carcinoma and to investigate the postoperative main cause of death of the esophageal carcinoma in different time. Metholds： A total of 2572 patients who received resection in our hospital during 50 years （from 1954 to 2003） were reviewed. They were divided into group A for the early 32 years （Jan.1954 to Dec. 1985） and group B for latter 18 years （Jan. 1986 to Dec. 2003）. The cause of death for postoperative patients was analyzed. Results： The 44 patients of group A died after operation. The mortality was 8.15% （44/ 540） and 72 patients in group B died after operation, with a mortality of 3.54% （72/2032）. Conclu- sions： The cause of death in group A is the same as in group B. The anastomotic fistula, respiration failure, heart failure, cardiovascular disease is the main cause of death for patients with esophageal carcinoma after operation.