CAJ | 학술논문

目的回顾性分析食管裂孔疝Belsey MarkⅣ手术患者的临床特点及修补手术的方法、安全性及临床效果，并对该手术的应用进行进一步的探讨。方法回顾性分析2006年10月至2014年6月，青岛市市立医院15例食管裂孔疝接受疝修补术患者的临床资料。其中男6例，女9例，年龄58～84岁，平均74．5岁，伴随其他疾病14例。结果15例患者均顺利完成手术，手术时间61～130 min，平均108 min；手术出血10～110 ml，平均25 ml；术后住院5～21 d，平均住院9 d。随访期内无死亡患者。1例重度吞咽困难患者经扩张后好转，1例出现食管破裂并发症，经再次手术行食管部分切除食管胃吻合术治愈，未发现食管裂孔疝症状性复发患者。结论 Belsey MarkⅣ手术修补食管裂孔疝相对安全可靠，尽管手术创伤较大，但是一项安全有效的手术方式，能够取得良好的临床效果，是复杂以及复发食管裂孔疝治疗的可靠选择。
목적회고성분석식관렬공산Belsey MarkⅣ수술환자적림상특점급수보수술적방법、안전성급림상효과，병대해수술적응용진행진일보적탐토。방법회고성분석2006년10월지2014년6월，청도시시립의원15례식관렬공산접수산수보술환자적림상자료。기중남6례，녀9례，년령58～84세，평균74．5세，반수기타질병14례。결과15례환자균순리완성수술，수술시간61～130 min，평균108 min；수술출혈10～110 ml，평균25 ml；술후주원5～21 d，평균주원9 d。수방기내무사망환자。1례중도탄인곤난환자경확장후호전，1례출현식관파렬병발증，경재차수술행식관부분절제식관위문합술치유，미발현식관렬공산증상성복발환자。결론 Belsey MarkⅣ수술수보식관렬공산상대안전가고，진관수술창상교대，단시일항안전유효적수술방식，능구취득량호적림상효과，시복잡이급복발식관렬공산치료적가고선택。
Objective To analysis the clinical feature , safety and efficacy of Belsey Mark Ⅳoperation for the esophageal hiatal hernia .The role of Belsey MarkⅣoperation was discussed.Methods There were 15 patients with esophageal hiatal hernia (6 males and 9 females,age ranged from 58 to 84 years old, 74.5 years old in average ) received Belsey MarkⅣoperation in Qingdao Municipal Hospital from October 2006 to June 2014 .There were 14 patients accompanied with other disease .Results All 15 patients were underwent Belsey MarkⅣsuccessfully.The operation time were 108 minutes in average(61-130 minutes)and blood loss were 10-110 ml,25 ml in average.Mean postoperative hospital stay were 9 days(5-21 days).No mortality was found .One patient with serious dysphagia was treated with dilatation .Esophagectomy was performed on a patient with esophageal rupture after Belsey Mark Ⅳoperation .No symptom recurrence was found.Conclusion Esophageal hiatal hernia was common in elderly patients .Belsey MarkⅣesophageal hiatal hernia repair surgery is safe and can achieve good clinical results .Above all,Belsey MarkⅣis the reliable choice for the patients with complex or recurrent hernia .