食管癌术后吻合口瘘原因分析及综合预防

Analysis to causes of postoperative anastomosing fistula of esophageal carcinoma and universal precautions

目的 分析食管癌术后吻合口瘘的原因,探讨综合预防措施。方法 统计1978年5月至1998年5月20年中,17例食管癌术后吻合口瘘每5年发生例数分布。结果 本组食管癌术后吻合口瘘病例,前10年13例,近10年4例;其发生率分别为5.73％(13/227)和1.17％(4/342),有逐年下降趋势。这与围手术期处理的完善、手术方式的改进及对可疑、好发瘘病人的特别关注有密切关系。结论 相对固定(程度化)的综合处理方法,在降低食管癌术后吻合口瘘发生率方面意义重大。

Objective To find the causes of postoperative anastomosing 17 cases of postoperative anatomosing fistula of esophageal carcinoma in the last 20 years from May, 1978 to May, 1998. Result There were 13 cases in the first ten year and 4 cases inthe second. The incidence of anastomosing fistula was 5. 73% ( 13/227) and 1. 17% (4/342) respectively. It was falling year by year and was associated with measures of peroperative period, improvement of operative manner and special attention to high- risk patients. Condusion Relative fixed routine of universal precautions was significant in reducing the incidence of postoperative ana - stomosing fistula of esophageal carcinoma.