异物性食管穿孔的治疗方法与疗效分析(附87例报告)

Treatment of esophageal perforation caused by foreign bodies (report of 87 cases)

目的总结异物性食管穿孔的治疗方法和疗效。方法回顾分析我院治疗的87例异物性食管穿孔患者的临床资料,颈段食管穿孔39例,保守治疗35例,手术治疗4例;胸段食管穿孔48例,保守治疗20例,手术治疗28例。结果39例颈段食管穿孔者均治愈。48例胸段食管穿孔者中保守治疗组死亡5例,2例死于严重纵隔及胸腔感染,3例死于主动脉出血,治愈15例;手术治疗组死亡2例,分别于术中和一期术后死于主动脉出血,治愈26例。结论颈段食管穿孔大部分可以保守治疗,胸段食管穿孔应以手术治疗为主。

Objective To review the treatment strategy and outcome of esophageal perforation caused by foreign bodies. Methods From January 1950 to June 2005, 87 patients with esophageal pedoration caused by foreign bodies were treated in our department. 39 patients were with cervical perforations. Among them 35 patients were treated by conservative treatment, 4 patients were treated surgically. There were 48 patients with thoracic perforations. Among them 20 patients were treated by conservative treatment, 28 patients were treated surgically. Results All the 39 patients with cervical perforations were cured. 15 out of the 20 patients with thoracic pedorations who were treated by conservative treatment were cured, 2 patients died of severe thoracic and mediastinal infection, 3 patients died of aortic hemorrhage. 26 out of the 28 patients with thoracic pedorations who were treated by operation were cured, 2 patients died of aortic hemorrhage during and after the operation respectively. Conclusions Most of patients with cervical perforations could treated by conservative treatment, whereas most of patients with thoracic pedorations should be treated surgically.