食管床低负压引流在食管癌术后胸内吻合口瘘早期诊断及治疗中的应用

发布时间：2019-04-27 04:51

【摘要】：目的吻合口瘘是食管癌术后严重的并发症。文中观察放置食管床低负压引流管对食管癌手术后胸内吻合口瘘早期诊断及疗效,并探讨食管床低负压引流的临床应用价值。方法回顾性分析2013年3月至2015年11月期间于济宁医学院附属湖西医院216例行食管胃胸内吻合术的食管癌患者临床资料。其中124例患者完成食管癌根治性切除食管胃胸内吻合后,置入常规胸腔闭式引流管及食管床低负压引流管各1根(低负压组);92例患者行食管癌根治性切除食管胃胸内吻合后,仅置入1根常规胸腔闭式引流管(对照组)。比较2组术后胸内吻合口瘘发生率的差异以及发生吻合口瘘病例的确诊时间与瘘后恢复(自确诊瘘至恢复经口进食)时间差异。结果低负压组与对照组术后吻合口瘘发生率差异无统计学意义(5.64%vs 4.34%,P0.05),发生食管胸内吻合口瘘患者吻合口瘘确诊时间[(5.43±1.62)d vs(8.25±2.22)d]及瘘后恢复时间[(29.29±10.18)d vs(78.50±20.27)d]差异有统计学意义(P0.05)。结论放置食管床低负压引流管有助于早期发现吻合口瘘的发生,有利于及早治疗及缩短吻合口瘘的瘘后恢复病程。
[Abstract]:Objective anastomotic fistula is a serious complication after esophageal carcinoma. In this paper, we observed the early diagnosis and curative effect of esophageal bed low negative pressure drainage tube for intrathoracic anastomotic fistula after esophageal cancer operation, and discussed the clinical application value of esophageal bed low negative pressure drainage. Methods from March 2013 to November 2015, 216 patients with esophageal carcinoma underwent gastrothoracic esophagostomy in Huxi Hospital affiliated to Jining Medical College were retrospectively analyzed. After radical resection of esophageal carcinoma, 124 cases were implanted with conventional closed thoracic drainage tube and low negative pressure drainage tube in esophageal bed (low negative pressure group). After radical resection of esophageal carcinoma and intrathoracic anastomosis, only one closed thoracic drainage tube was placed in 92 patients (control group). The differences in the incidence of intrathoracic anastomotic fistula between the two groups were compared, and the time of diagnosis of anastomotic fistula and the time of recovery (from confirmed fistula to recovery of oral feeding) were compared between the two groups. Results there was no significant difference in the incidence of anastomotic fistula between the low negative pressure group and the control group (5.64%vs 4.34%, P0.05). There were statistical differences in the time of diagnosis of anastomotic fistula [(5.43 卤1.62) d vs (8.25 卤2.22) days] and post-fistula recovery time [(29.29 卤10.18) d vs (78.50 卤20.27) days] in patients with esophageal intrathoracic anastomotic fistula. The significance of learning (P0.05). Conclusion the placement of low negative pressure drainage tube in esophageal bed is helpful for early detection of anastomotic fistula and for the early treatment and shortening of the course of recovery of anastomotic fistula.
【作者单位】：济宁医学院附属湖西医院(单县中心医院)心胸外科;
【分类号】：R735.1

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