CAJ | 학술논문

目的：探讨食管切除术后胸内吻合口漏的原因、治疗及预防。方法1812例食管切除术患者55例术后发生胸内吻合口漏，其中28例行非手术治疗，27例行手术治疗。结果非手术治疗的28例吻合口漏中，22例治愈，4例死亡，2例放弃治疗；手术治疗的27例中，26例治愈，死亡1例为吻合口漏修补术后再次发生吻合口漏，多脏器功能衰竭死亡。结论食管切除术后胸内吻合口漏病情危重，死亡率高，术中及围手术期采取有效预防措施可降低吻合口漏的发生率。治疗应首先采用非手术方法，如无好转应尽早手术治疗。治疗目的在于通畅引流，辅以肠内营养可取得较好治疗效果。
목적：탐토식관절제술후흉내문합구루적원인、치료급예방。방법1812례식관절제술환자55례술후발생흉내문합구루，기중28례행비수술치료，27례행수술치료。결과비수술치료적28례문합구루중，22례치유，4례사망，2례방기치료；수술치료적27례중，26례치유，사망1례위문합구루수보술후재차발생문합구루，다장기공능쇠갈사망。결론식관절제술후흉내문합구루병정위중，사망솔고，술중급위수술기채취유효예방조시가강저문합구루적발생솔。치료응수선채용비수술방법，여무호전응진조수술치료。치료목적재우통창인류，보이장내영양가취득교호치료효과。
Objective To evaluate the etiological factors,diagnosis,treatment and prevention of anasto-motic leakage in thoracic cavity after esophagectomy. Methods There were 55 cases of anastomotic leakage a-mong 1812 patients after taking the operation of esophagectomy. 28 patients were treated with non-operative treatment,27 patients were treated with operational treatment. Results 22 of 28 patients with non-operative treatment were cured,4 cases of death,2 cases were discharged voluntarily after giving up therapy;26 of 27 ca-ses with operational treatment were cured. One case of postoperative recurrence of anastomotic leakage died of multiple organ failure. Conclusion The mortality rate of anastomotic leakage is higher in thoracic cavity after esophagectomy,and the active preventive measures therapy may reduce the incidence of anastomotic leakage. Treatment should be used non-surgical methods firstly. If there is no improvement,surgical treatment is sup-posed to be taken as soon as possible. The treatment aims to keep effective drainage,supplemented by enteral nutrition could get better therapeutic effect.