双负压引流冲洗装置治疗食管癌术后颈部吻合口瘘疗效观察

Clinical research of the treatment on cervical esophagus fistula with double negative pressure drainage and flushing device

目的 探讨双负压引流装置引流法在食管癌术后颈部吻合口瘘治疗中的临床效果,寻找吻合口瘘的有效治疗方法。方法 回顾性分析2020-03-1-2021-10-20山东省肿瘤医院胸外科食管癌术后出现颈部吻合口瘘的30例患者临床资料,其中11例采用双负压引流管引流治疗,19例采用传统的切口敞开引流换药治疗,比较两组患者发现瘘后痊愈时间、换药次数、颈部出血发生情况。结果 双负压引流组患者颈部吻合口瘘愈合时间为(9.55±2.23)d,低于敞开换药组的(21±10.17)d,差异有统计学意义,P<0.001;双负压引流组换药次数为(11.64±6.65)次,低于敞开换药组的(25.84±12.60)次,差异有统计学意义,P<0.001;双负压引流组颈部出血率为0,低于敞开换药组的5.26%(1/19),差异无统计学意义,P=1.000。结论 双负压引流装置引流法对食管癌术后颈部吻合口瘘安全、可行、有效,值得临床推广。

Objective To explore the clinical effect of double negative pressure drainage on cervical esophagus fistula after esophageal carcinoma surgery, and search for the effective treatment methods.Methods The clinical data of 30 patienls with cervical esophagus fistula after esophageal carcinoma surgery in the same medical group of Thoracic Surgery Department, Shandong Cancer Hospital and Institute from March 2020 to October 2021 were retospective analyzed.Among them, 11 cases were treated with low negative pressure suction by double caping pipe as experimental group, 19 cases were treated with conventional drainage and dresslng as the control group.The healing time, dressing frequency, neck bleeding risk between two groups were analyzed and compared.Results The healing time of neck fistula and the number of dressing changes in the double negative pressure drainage group were(9.55±2.23) days and(11.64±6.65) times, respectively, which were significantly lower than those in the open dressing change group(21.00±10.17) days and(25.84±12.60) times, and the difference between the two groups was statistically significant(both P<0.001).The rate of neck bleeding in the observation group was 0,which was lower than that in the control group(5.26%),but the difference was not statistically significant(P=1.000).Conclusion Double negative pressure drainage is safe, feasible and efficacious for treatment of anastomotic leakage after esophagectomy, and it is worthy of clinical promotion.