食管癌贲门癌术后吻合口及胸胃瘘的临床探析

Clinical Analysis of Esophageal and Cardiac Anastomotic Mouth and Chest Gastric Fistula

目的对食管癌、贲门癌手术后发生吻合口瘘及胸胃瘘的病发原因、有效防治措施和高危因素进行探讨。方法对进行食管癌、贲门癌手术切除的1346例进行分析,将发生的术后并发症的原因、临床特征、诊治体会总结。结果手术后确认发生吻合口瘘、胸胃瘘的80例,除有2例双肺继发性感染导致休克和脏器衰竭而死亡,其余经过治疗后痊愈,病死率0.025%。结论①操作技巧和吻合方式对术后吻合口瘘有重要影响;②肺部感染和器官衰竭是导致死亡的主要因素;③胸管、胃管和营养管的畅通是治疗关键。

Objective Esophageal cancer, gastric cardia after surgery anastomotic leakage and thoracic stomach fistula of the cause, explore effective prevention and control measures and risk factors. Methods 1346 cases of esophageal cancer, gastric cardia surgical resection to analyze the cause of postoperative complications will occur, clinical characteristics, diagnosis and treatment experience are summarized. Results Recognized in the post-operative anastomotic leakage occurred, thoracic stomach fistula in 80 cases, in addition to the two cases of lung secondary infection causes shock and organ failure and death, and the rest recovered af- ter treatment, the fatality rate was 0.025%. Conclusion ① Operating skills and anastomosis on postoperative anastomotic leakage have a major impact; the ② lung infection and organ failure is the leading cause of death; the ③chest tube, gastric tube feeding tube smooth is the key to the treatment.