先天性食道闭锁25例分析

Clinical Analysis of 25 Cases with Congenital Esophageal Atresia

目的 探讨先天性食道闭锁早期诊断、治疗与预后的关系。方法 回顾性分析近 8年 2 5例食道闭锁诊治经验和存活 9例随访资料。结果 生后 2天之后才确诊本病者肺炎并发症占 89.47% ,食道上下端距离1 .5～ 3.5cm者术后吻合口漏发生率 80 % (4/ 5 ) ;术后肺炎加重和吻合口漏等并发症是死亡的主要原因。结论 早期诊断 ,术后ICU细心监护 ,及时防治并发症是先天性食道闭锁手术成功的关键。

Objective To study the prognosis after early diagnosis and treatment of infants with congenital esophageal atresia (CEA). Methods The treatment in 25 cases with CEA during the 1991～1998 period and the follow up data of 9 infants who survived were retrospectively analyzed. Results Pneumonia occurred in 89.47% of the infants with CEA which was diagnosed 2 days after birth. Anastomotic leaks after surgical operation occurred in 80%(4/5) of the cases in which the distance from the distal to the proximal esophageal pouches was 1.5～3.5 cm. The main causes of death were exacerbated pneumonia and complications secondary to anastomotic leaks after surgical operation. Conclusions Early diagnosis, improved intensive care, management and prevention of postoperative complication at the right moment are the key of successively operation on infants with CEA.