胸段食管穿孔的外科治疗(附21例报告)

Treatment on thoracic esophageal perforation (21 cases report)

目的 :通过对 2 1例胸段食管穿孔的分析 ,探讨其外科治疗方法。方法 :保守治疗 10例 ,食管修补术 6例 ,食管旷置后重建术 2例 ,食管切除后重建术 3例。结果 :治愈 16例 (76 19% ) ,死亡 5例 (2 3 81% )。结论 :早期诊断和及早准确治疗是影响疗效的关键 ,充分通畅的胸腔引流和胸腔灌洗是治疗的重要环节 ,综合分析穿孔时间、部位、大小、感染程度。

Objective: To investigate the therapeutical method of thoracic esophageal perforation.Methods: 21 cases of thoracic esophageal perforation were studied carefully.The 21 patients had been treated by various methods,which included:conservative therapy(n=10),repair of esophageal defect(n=6),esophageal reconstruct(n=5).Results: 76.19%(16/21) of the patients recovered without any complications,but there was 23.81%(5/21) death rate.Conclusion: Early diagnosis and instant and correct management were the key in curing esophageal perforation.Sufficient thoracic cavum drainage and washing were important.Different therapeutical methods should be chosen according to the time,situs,length and infectious severity of the perforation,complication and general condition.