中国医药科学
中國醫藥科學
중국의약과학
CHINA MEDICINE AND PHARMACY
2014年
6期
209-211
,共3页
食管破裂%食管穿孔%诊断%治疗
食管破裂%食管穿孔%診斷%治療
식관파렬%식관천공%진단%치료
Esophageal rupture%Esophageal perforation%Diagnosis%Treatment
目的：探讨食管破裂与穿孔的诊断与治疗，提高对该疾病的诊治水平。方法总结分析我科15例食管破裂与穿孔的临床病例资料。颈段食管穿孔3例，2例为异物所致，1例为外伤所致，均手术治疗，胸段食管破裂穿孔12例，其中自发性食管破裂穿孔4例，食管异物损伤5例，外伤性食管穿孔2例，医源性损伤1例，根据食管的损伤程度及感染累及范围分别采取食管切开异物取出食管修补，食管部分切除，纵隔引流，瘘口修补等手术治疗12例。结果15例食管破裂与穿孔治愈13例；1例死于合并糖尿病因胸腔和纵隔感染严重，中毒性休克，呼吸衰竭，肾功能衰竭；1例死于食管癌引发食管破裂穿孔致感染性休克，多器官衰竭。结论根据食管破裂与穿孔的大小、时间、部位、纵膈和胸腔污染程度，早期明确诊断，及时采取合适的手术方式是治疗的关键。
目的：探討食管破裂與穿孔的診斷與治療，提高對該疾病的診治水平。方法總結分析我科15例食管破裂與穿孔的臨床病例資料。頸段食管穿孔3例，2例為異物所緻，1例為外傷所緻，均手術治療，胸段食管破裂穿孔12例，其中自髮性食管破裂穿孔4例，食管異物損傷5例，外傷性食管穿孔2例，醫源性損傷1例，根據食管的損傷程度及感染纍及範圍分彆採取食管切開異物取齣食管脩補，食管部分切除，縱隔引流，瘺口脩補等手術治療12例。結果15例食管破裂與穿孔治愈13例；1例死于閤併糖尿病因胸腔和縱隔感染嚴重，中毒性休剋，呼吸衰竭，腎功能衰竭；1例死于食管癌引髮食管破裂穿孔緻感染性休剋，多器官衰竭。結論根據食管破裂與穿孔的大小、時間、部位、縱膈和胸腔汙染程度，早期明確診斷，及時採取閤適的手術方式是治療的關鍵。
목적：탐토식관파렬여천공적진단여치료，제고대해질병적진치수평。방법총결분석아과15례식관파렬여천공적림상병례자료。경단식관천공3례，2례위이물소치，1례위외상소치，균수술치료，흉단식관파렬천공12례，기중자발성식관파렬천공4례，식관이물손상5례，외상성식관천공2례，의원성손상1례，근거식관적손상정도급감염루급범위분별채취식관절개이물취출식관수보，식관부분절제，종격인류，루구수보등수술치료12례。결과15례식관파렬여천공치유13례；1례사우합병당뇨병인흉강화종격감염엄중，중독성휴극，호흡쇠갈，신공능쇠갈；1례사우식관암인발식관파렬천공치감염성휴극，다기관쇠갈。결론근거식관파렬여천공적대소、시간、부위、종격화흉강오염정도，조기명학진단，급시채취합괄적수술방식시치료적관건。
Objective To investigate the diagnosis and treatment of esophageal rupture and perforation in order to improve the diagnosis and treatment level of this disease. Methods Clinical data of 15 patients with esophageal rupture and perforation in our department were summarized and analyzed. There were 3 cases of cervical segment esophageal perforation,of which 2 cases were caused by foreign matters and 1 case was caused by trauma,and all cases were treated by surgery. There were 12 cases of thoracic segment esophageal rupture and perforation,of which 4 cases were spontaneous esophageal rupture and perforation,5 cases were esophageal foreign matter injury,2 cases were traumatic esophageal perforation,and 1 case was iatrogenic injury. According to the injury degree of esophagus and the infection involved area,12 patients received esophageal incision,foreign body removal and esophageal repair,esophageal partial resection,mediastinum drainage,orificium fistulae repair and other surgical treatment respectively. Results Of the 15 patients with esophageal rupture and perforation,13 patients were cured.1 patient died of complicating diabetes and toxic shock,respiratory failure and renal function failure caused by severe thoracic cavity and mediastinum infection.1 patient died of septic shock and multi-organ failure caused by esophageal cancer-induced esophageal rupture and perforation. Conclusion Early and definite diagnosis and timely application of appropriate surgical methods based on the size,time,location,mediastinum and thoracic cavity infection degree of esophageal rapture and perforation are key to the treatment.
