CAJ | 학술논문

目的：通过回顾性分析食管闭锁并气管食管瘘患儿的临床资料,了解食管闭锁术后吻合口狭窄的的发生率、其可能的相关因素及食管扩张对吻合口狭窄的治疗意义。方法回顾性分析我院1994年1月至2013年12月进行手术的155例先天性食管闭锁并气管食管瘘患儿的临床资料。结果17例患儿出现食管吻合口狭窄(ⅢA型4例,ⅢB型13例),食管吻合口狭窄发生率11.0%,56例食管吻合口瘘,发生率36.1%(ⅢA型17例,ⅢB 型39例)。经卡方检验,食管吻合口漏的患儿与无漏患儿在食管狭窄的发生上差别有统计学意义,但吻合口漏、吻合口狭窄的发生在不同分型间差异无统计学意义。17例患儿进行食管扩张频次共计63次,平均扩张次数为3.71次/人。结论食管闭锁并气管食管瘘的患儿出现吻合口狭窄与食管盲端与远端瘘管间的距离无关。术后食管吻合口瘘患儿更容易出现吻合口狭窄(P=0.009)。食管吻合口狭窄可通过食管扩张缓解。
목적：통과회고성분석식관폐쇄병기관식관루환인적림상자료,료해식관폐쇄술후문합구협착적적발생솔、기가능적상관인소급식관확장대문합구협착적치료의의。방법회고성분석아원1994년1월지2013년12월진행수술적155례선천성식관폐쇄병기관식관루환인적림상자료。결과17례환인출현식관문합구협착(ⅢA형4례,ⅢB형13례),식관문합구협착발생솔11.0%,56례식관문합구루,발생솔36.1%(ⅢA형17례,ⅢB 형39례)。경잡방검험,식관문합구루적환인여무루환인재식관협착적발생상차별유통계학의의,단문합구루、문합구협착적발생재불동분형간차이무통계학의의。17례환인진행식관확장빈차공계63차,평균확장차수위3.71차/인。결론식관폐쇄병기관식관루적환인출현문합구협착여식관맹단여원단루관간적거리무관。술후식관문합구루환인경용역출현문합구협착(P=0.009)。식관문합구협착가통과식관확장완해。
Objective To identify the risk factors of anastomotic strictures (AS ) after esophageal atresia (EA)repair and explore the efficacies of esophageal dilatations for AS.Methods Retrospective analyses were performed for the data of 155 EA patients with trachoesophageal fistula (Gross type Ⅲ)patients undergoing esophageal anastomosis at our institution between January 1994 and December 2013.Results A total of 17 cases developed AS (type A,n=4;type B,n=13).The AS rate was 1 1 .0% and anastomotic leak rate 36.1%.By chi-square test,the difference of those with anastomotic stricture with or without leakage was statistically significant.No statistical differences existed in anastomotic leak or stricture between different classifications.Sixty-three dilation sessions were performed with an average of 3.71 (1-10)sessions per patient.Conclusions The distance between proximal blind pouch and distal fistula has no correlation with an elevated risk of AS.Patients of an anastomotic leak have an elevated risk of developing AS (P=0.009).Stricture may be managed by subsequent esophageal dilatations.