Stapler技术治疗颈段气管食管瘘的临床疗效分析

发布时间：2018-03-03 13:09

本文选题：气管食管瘘　切入点：stapler　出处：《兰州大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:研究Stapler技术在治疗颈段气管食管瘘中的临床疗效。方法:回顾性分析2014年10月-2016年10月在兰州大学第二医院胸外科收治的8例气管食管瘘患者的临床资料,男女之比为5:3,其中4例患者气管食管瘘由气管插管导致,2例由食管异物导致,1例由气管支架导致,1例由食管憩室导致;他们全部接受Stapler技术闭合瘘口,术后通过KPS评分、影像学改善情况、患者满意度调查和患者进食呛咳症状改善情况来评价手术效果。结果:手术过程顺利,手术时间为(117.5±6.6)min,术中出血量为(60±7.0)mL。术后患者无切口出血感染、无声音嘶哑呼吸困难、无饮水呛咳、无瘘口复发、无气管食管狭窄等并发症,无围手术期死亡病例,1周后拍胸部X线片示肺部感染症状消失,仅有1例患者术后1年出现食管狭窄。术后2周KPS(Karnofsky-功能状态评分)评分为(90±7.0),较术前明显改善(p0.01),术后肺部感染面积较术前减少(p0.05),气管食管瘘道消失,患者总体满意率为90%,进食呛咳症状改善情况评价为优。结论:Stapler技术是治疗颈段气管食管瘘的有效术式,具有安全、简便,手术时间短,术后并发症少,疗效可靠等优点。
[Abstract]:Objective: to study the clinical effect of Stapler in the treatment of cervical tracheoesophageal fistula. Methods: the clinical data of 8 patients with tracheoesophageal fistula treated in Department of Thoracic surgery, second Hospital of Lanzhou University from October 2014 to October 2016 were retrospectively analyzed. The ratio of male to female was 5: 3, of which 4 patients had tracheoesophageal fistula caused by tracheal intubation, 2 patients by esophageal foreign body, 1 by tracheal stents, 1 by esophageal diverticulum, they all received Stapler technique to close the fistula, which was scored by KPS after operation. Results: the operation process was smooth, the operation time was 117.5 卤6.6 min, the intraoperative bleeding volume was 60 卤7.0 mL. there was no wound bleeding infection after operation. There were no complications such as hoarseness dyspnea, no coughing in drinking water, no recurrence of fistula, no tracheoesophageal stenosis and so on. The chest X-ray film taken after 1 week of perioperative death showed that the symptoms of pulmonary infection disappeared. Only one patient developed esophageal stricture one year after operation. The score of KPSN Karnofsky- functional state at 2 weeks after operation was 90 卤7.0, which was significantly better than that before operation (P 0.01). The area of postoperative pulmonary infection was reduced by p0.05 and the tracheoesophageal fistula disappeared. The overall satisfaction rate of the patients was 90, and the improvement of choking cough symptom was superior. Conclusion: Stapler technique is an effective method for the treatment of cervical tracheoesophageal fistula. It has the advantages of safety, simplicity, short operation time, less postoperative complications, reliable curative effect, and so on.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R653

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