食管异物致穿孔并颈部脓肿的诊治

The diagnosis and treatment of esophageal perforation and neck abscess induced by esophageal foreign body

目的:总结分析食管异物致穿孔并脓肿的临床特点及治疗方法,以提高对该病的诊治水平。方法:26例食管异物致食管穿孔并颈部脓肿患者均在全身麻醉下行食管镜检异物取出术。结果:经食管镜取出异物24例,2例未见异物。治愈25例,转胸外科1例。结论:对于食管异物致食管穿孔及颈部脓肿患者,术前应常规完善CT扫描,及时取出异物;同时放置鼻饲管,使食管旷置,以免食物经穿孔处溢出而加重感染;足量抗生素和加强营养支持可提高治愈率。

Objective：To explore the clinical characteristics and treatment methods of esophageal perforation and neck abscess induced by esophageal foreign body.Method：Twenty-six cases with esophageal perforation and neck abscess caused by esophageal foreign body treated in our department were peformed surgery under general anesthesia.Result：The foreign bodies were removed via esophagoscope in 24 cases,no foreign bodies were found in 2 cases.Twenty-five case cured and one case was sent to the department of thoracic surgery.Conclusion：For the patients with esophageal perforation and neck abscess,regular perfect preoperative CT scan,timely take out foreign body;meanwhile indwelling nasal-stomach tube,the vacancy of the esophagus,avoid food spillage through the perforation and aggravating infection;adequate antibiotics and nutritional support can improve the cure rate.