食管异物并发食管穿孔及颈部脓肿临床分析

发布时间：2018-06-28 12:17

本文选题：食管异物 + 穿孔　；参考：《临床耳鼻咽喉头颈外科杂志》2014年07期

【摘要】：目的:探讨食管异物并发食管穿孔及颈部脓肿的临床特点及治疗方法,以期提高对该病的诊治水平。方法:24例食管异物并发食管穿孔及颈部脓肿患者均在全身麻醉下行食管镜检查异物取出术,其中经食管镜取出异物14例,开胸后取出义齿3例,颈侧切开取出异物5例;余2例未见异物。结果:24例患者中并发脓肿16例,其中食管周围脓肿10例,颈部脓肿4例,纵隔脓肿2例;治愈21例,死亡1例,1例因血糖高转内分泌科,1例转胸外科继续治疗。结论:早期诊断、早期治疗是处理食管异物并发食管穿孔的关键。对于食管异物并发食管穿孔及颈部脓肿患者行薄层CT扫描具有极高的诊断及鉴别诊断价值。颈部脓肿一经确诊,应及时行脓肿切开引流术,合理应用抗生素,有效控制感染及并发症的发生,加强营养支持治疗可提高治愈率。
[Abstract]:Objective: to investigate the clinical features and treatment of esophageal foreign body complicated with esophageal perforation and cervical abscess in order to improve the diagnosis and treatment of the disease. Methods Twenty four cases of esophageal foreign body complicated with esophageal perforation and cervical abscess were examined by esophagoscope under general anesthesia. Foreign bodies were removed by esophagoscope in 14 cases, denture in 3 cases after thoracotomy, and foreign body in 5 cases by lateral cervical incision. No foreign bodies were found in the remaining 2 cases. Results among 24 cases, 16 cases were complicated with abscess, including 10 cases of periesophageal abscess, 4 cases of cervical abscess, 2 cases of mediastinal abscess, 21 cases of cure and 1 case of death. Conclusion: early diagnosis and treatment are the key to deal with esophageal foreign body complicated with esophageal perforation. Thin-slice CT scan for esophageal foreign body complicated with esophageal perforation and cervical abscess is of great value in diagnosis and differential diagnosis. Once the diagnosis of cervical abscess is confirmed, incision and drainage of abscess should be performed in time, antibiotics should be used rationally, infection and complications can be effectively controlled, and the cure rate can be improved by strengthening nutritional support therapy.
【作者单位】：四川省人民医院耳鼻咽喉科;
【分类号】：R768

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