获得性气道食管瘘的研究现状

Research status of acquired tracheoesophageal Fistula

获得性气道食管瘘是临床少见病,其病因复杂,创伤、肿瘤、异物及感染是其常见原因。临床特征表现为吞咽或进食后阵发性呛咳,部分患者可表现为复发性肺炎,气管插管患者多起病隐匿。胸部CT和磁共振的诊断敏感度有限。食管或气管X线造影具有重要诊断价值,胃镜和支气管镜检查可确诊。外科手术治疗、内科保守治疗、内镜介入治疗是获得性气道食管瘘的主要治疗手段。气道食管瘘治疗效果有限,预防气道食管瘘的发生是临床的重点。本综述从获得性气道食管瘘的发病原因、临床表现、诊断方法、治疗手段和预防方法等方面进行分析,帮助临床医师进一步了解获得性气道食管瘘的诊疗方案,从而给予规范的处理,改善其预后。

Acquired tracheoesophageal fistula is a rare clinical disease with complicated etiology. The common causes include trauma, tumor, foreign body and infected disease. The clinical features arc characterized by paroxysmal cough after swallowing or eating, recurrent pneumonia in some patients and occult diseases in patients with endotracheal intubation. The diagnostic sensitivity of chest computed tomography and magnetic resonance imaging is limited. Xray radiography of esophagus or trachea has an important diagnostic value,Gastroscopy and bronchoscopy can confirm the diagnosis. The main treatment methods of acquircd tracheoesophageal fistula include surgical treatment, internal conservative treatment and endoscopic intervention. The therapeutic effect is not good. The prevention of tracheoesophageal fistula is the key point. This review analyzes the causes, clinical manifestations, diagnosis methods, treatment methods and prevention methods of acquircd tracheoesophageal fistula, help clinicians further understand the diagnosis and treatment programs, so as to give standardized treatment and improve its prognosis.