食管癌术后胸胃穿孔7例临床分析

Clinical Analysis on 7 Cases with Gastric Perforation after Resection of Esophageal Carcinoma

目的研究食管癌切除术后并发胸胃穿孔的原因及治疗方法,探讨其预防措施。方法食管癌切除术后并发胸胃穿孔7例,2例手术(开胸胃修补)、5例保守治疗(胸腔闭式引流、胃肠减压、营养支持、抗感染等)。结果本组治愈6例,死亡1例。结论食管癌切除术后一旦并发胸胃穿孔,掌握手术适应证,及时手术并综合治疗是安全、有效的办法。手术操作轻柔、胸胃游离充分、术后胃管护理是预防并发症的关键。

Objective To study the reasons and the treatment of gastric perforation after the resection of esphageal carcinoma,and investigate their preventive measure. Methods After resection esophageal carcinoma,7 cases were diagnosed as gastric perforation.Among them 2 patients were managed surgically（Operating the chest to patch）,the other 5 cases were treated conservatively（Chest cavity closed type drainage,stomach and intestines reduced pressure,nutrition support,anti-infection and so on）. Results Six cases were cured and 1 case died. Conclusion Once the concurrent thoracic esophageal resection gastric perforation,Grasp the surgery indication,the prompt surgery and the complex therapy is the security,the effective means.The surgery operates,chest stomach dissociation to be full gently,after the technique,stomach tube nursing are keys of preventing the complication.