CAJ | 학술논문

目的探讨梨状窝穿孔的诊断和治疗方法.方法 15例梨状窝穿孔患者大部分伴有咽部疼痛或发热,均行X线食管碘油造影和CT检查明确诊断.其中9例采取禁食,静脉应用广谱抗生素和营养支持等保守治疗；6例采取瘘口修补或颈部引流等手术治疗.结果 15梨状窝穿孔患者中,症状较轻且未发生严重并发症的9例采取保守治疗2周后治愈.6例有严重并发症的患者中3例采用颈部或上纵隔引流,3例采用瘘口修补术.所有患者均于治疗后2～4周行X线食管碘油造影检查,穿孔均愈合,随访1 ～ 30个月,无再发梨状窝穿孔.结论病程不超过12 h或症状较轻无明显并发症的梨状窝穿孔应采取保守治疗,对症状重、穿孔大且有严重并发症者应积极手术治疗.梨状窝穿孔的早期诊断和积极有效的治疗,可促进穿孔的愈合,减少并发症.
목적 탐토리상와천공적진단화치료방법.방법 15례리상와천공환자대부분반유인부동통혹발열,균행X선식관전유조영화CT검사명학진단.기중9례채취금식,정맥응용엄보항생소화영양지지등보수치료；6례채취루구수보혹경부인류등수술치료.결과 15리상와천공환자중,증상교경차미발생엄중병발증적9례채취보수치료2주후치유.6례유엄중병발증적환자중3례채용경부혹상종격인류,3례채용루구수보술.소유환자균우치료후2～4주행X선식관전유조영검사,천공균유합,수방1 ～ 30개월,무재발리상와천공.결론 병정불초과12 h혹증상교경무명현병발증적리상와천공응채취보수치료,대증상중、천공대차유엄중병발증자응적겁수술치료.리상와천공적조기진단화적겁유효적치료,가촉진천공적유합,감소병발증.
Objective To investigate the early diagnosis,treatment and prognosis of pyriform sinus perforation.Methods Fifteen patients were diagnosed to have pyriform sinus perforation,most of them were associated with pharyngeal pain or fever.Contrast X-ray and CT scan were used to confirm the perforation.Results Conservative treatment was used in 9 cases with wild symptoms and surgical intervention in 6 cases with severe symptoms and complications.Both methods achieved better clinical efficacy.By relevant examination,the perforation healed within 2-4 weeks and none had re-perforation for 1-30 months follow-up.Conclusions Pyriform sinus perforation with wild symptoms and within 12 hours can be treated conservatively.Large perforation(＞ 2 cm)last more than 12 hours or with any complications require exploration,surgical repair if possible and adequate drainage.Early diagnosis and effective treatment can reduce the incidence of complications and improve the survival rate of patients.