食道癌根治术后吻合口瘘6例临床观察

CLINICAL OBSERVATION OF 6 CASES OF ANASTOMOTIC FISTULA AFTER RADICAL OPERATION OF ESOPHAGUS CARCINOMA

目的分析食道癌根治术后吻合口瘘的临床治疗,总结吻合口瘘发生的原因、早期诊断及预防和治疗的方法。方法对6例吻合口瘘患者采用禁食、胃肠减压、保持胸腔引流通畅、控制胸腔感染、全面的营养支持治疗并尽早使用肠内营养,以及于瘘口位置放置食管内支架、封堵瘘口的方法。结果 5例治愈出院,1例因吻合口瘘破溃入右侧主支气管,导致肺部严重感染,低血氧症,破溃后26 h后死亡。结论对于吻合口瘘的患者,早期诊断及采取针对性的治疗,可明显提高患者的治愈率,降低死亡率。

Objective Analyze the treatment of 6 cases anastomotic fistula in patients after radical operation for esophageal carcinoma, summarize the reason of anastomotic leakage, early diagnosis, prevention and treatment. Methods In patients with anastomotic fistula, we used the treatment of fasting, gastrointestinal decompression, keeping the pleural drainage, controlling pleural infection, comprehensive nutrition supporting therapy and the early use of enteral nutrition, as well as placing esophageal stent in fistula to close fistula. Results 5 cases were cured and discharged, 1 case the anastomotic fistula ruptured intt~ right main bronchus induced severe pulmonary infection, hypoxemia and died 26 h after rupture. Conclusion In patients with anastomotic fistula, early diagnosis and targeted therapy may improve patient cure rates, lower mortality.