食管癌患者80例围手术期处理

Perioperative management for 80 cases of esophageal cancer

目的:探讨食管癌的诊断、外科治疗及围手术期处理,提高术前诊断率、手术效果及减少并发症的发生率。方法:80例术前均经钡餐造影及纤维胃镜确诊为食管癌。均行手术治疗,并做好围手术期处理。结果:手术切除率97.5%(78/80);术后吻合口瘘6例,吻合口狭窄1例,吻合口出血2例,乳糜胸1例,肺部感染9例,术后1个月内未出现病死病例。结论:术前要行X线钡餐摄片与内镜活组织病理检查以减少漏诊率。积极做好围手术期处理,对增加患者肿瘤切除率、减少并发症及改善预后有较大帮助。

Objective： To explore the diagnosis, surgical treatment and preoperative management for esophageal cancer, improve preoperative diagnosis rate, curative effect and reduce complications. Methods： All of 80 cases were diagnosed by barium meal radiography and gastroscope, and all were treated with surgical methods and carefully preoperative management. Results：Surgical radical resection rate was 97.5% （ 78/80 ）. Postoperative complications were including 6 cases of leakage, 1 case of anastomotic stricture, 2 cases of anastomotic bleeding, 1 case of chylothorax and 9 cases of lung infection. There was no death case during one month after operation. Conclusions：Esophageal cancer must be diagnosed by barium meal and gastroscope, which can reduce the rate of missed diagnosis. Doing a good preoperative management is helpful to improve the resection rate of the tumor, reduce the complications and improve the prognosis of esophageal cancer.