胸腔胃-气管瘘6例报告

Thoracostomach-airway Fistula with 6 Cases Report

目的探讨胸腔胃-气管瘘的主要病因、临床表现特点、诊断与治疗。方法回顾性分析胸腔胃-气管瘘6例的临床资料。结果6例胸腔胃-气管瘘均发生于放疗后,临床表现为特征性的卧位烧灼样刺激性呛咳,数字化X射线摄影系统口服碘水造影或螺旋CT扫描确诊胸腔胃-气管瘘2例,胸腔胃-右主支气管瘘1例,胸腔胃-左主支气管瘘3例;4例行带膜气道支架置入术,呛咳症状消失;2例行内科保守治疗。结论胸腔胃-气管瘘的主要病因为放疗损伤,特征性临床表现为卧位烧灼样刺激性呛咳,确诊依靠数字化X射线摄影系统口服碘水造影或行螺旋CT扫描,治疗应采用以放置带膜气道支架为主的综合治疗。

Objective To explore the main cause,clinical characteristics,diagnosis and treatment for thoracostomach-airway fistula.Methods The clinical data of 6 thoracostomach-airway fistula cases were analyzed retrospectively.Results All 6 patients with thoracostomach-airway fistula occurred after radioactive treatment.Clinical manifestations included heartburn-like and irritative choke in decubitus.Diagnosis of thoracostomach-airway fistula was made on digital radiography with water-soluble medium and spiral computed tomography.There were 2 patients with thoracostomach-tracheal fistulas,1 patient with thoracostomach-right main bronchial fistula,and 3 patients with thoracostomach-left main bronchial fistula.4 patients were treated with covered metallic stents and 2 cases were treated by conventional internal methods.Conclusion The main cause of thoracostomach-airway fistula is radioactive injury.The characteristic clinical manifestation is heartburn-like and irritative choke in decubitus.Diagnosis of thoracostomach-airway fistula depends on digital radiography with water-soluble medium and spiral computed tomography.The main treatment is using covered metallic stent to seal off the thoracostomach-airway fistula.