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目的总结食管癌切除颈吻合术后并发胸腔瘘的诊断和治疗经验。方法分析1998-01-2010-01食管癌切除颈吻合术后并发胸腔瘘患者8例,发现颈吻合区漏入胸腔4例,胸内胃残端瘘4例。均采用保守治疗,包括置入鼻胃肠营养管、胸腔引流冲洗、联合应用抗生素等。结果 1例死于多器官功能衰竭,其余痊愈,平均住院38.3 d。结论食管癌切除颈吻合术仍有可能发生消化道胸腔瘘,一旦确诊,宜立即给予胃肠减压、营养支持、胸腔引流、应用抗生素等综合治疗。
Objective To summarize the experience of diagnosis and treatment of thoracic fistula after esophageal resection of cervical anastomosis. Methods Analysis of 8 patients with thoracic fistula after resection of cervical anastomosis in esophageal cancer from January 1998 to October 2010-01. Four cases of thoracic gastric stump fistula were found in 4 cases. Both conservative treatment, including the placement of nasogastric tube, chest drain irrigation, combined antibiotics and so on. Results 1 case died of multiple organ failure, the rest recovered, the average hospitalization 38.3 d. Conclusion Esophageal resection of cervical anastomosis is still possible gastrointestinal fistula, once diagnosed, should immediately give gastrointestinal decompression, nutritional support, chest drainage, the application of antibiotics and other comprehensive treatment.