摘要
目的探讨食管癌术后并发胸内吻合口瘘性脓胸发生的原因、诊断方法及治疗预防措施。方法对2000年1月-2006年12月手术切除的食管贲门癌624例中,发生胸内吻合口瘘性脓胸14例的临床资料进行回顾性分析。结果全部病例行胸腔闭式引流,9例放置上、下胸管,采用胸腔冲洗加闭式引流治疗、痊愈;2次开胸即重行吻合3例成功,1例转送上一级医院后死亡,1例因中毒性休克、呼吸衰竭、不能再次手术而死亡。结论严格选择病例、充分做好术前准备、注意手术操作、改进吻合方法、改善吻合口周围血运,加强术后环节管理,口腔及各种引流管的护理,是预防胸内吻合口瘘性脓胸关键措施。
OBJECTIVE To investigate the cause, diagnosis and treatment of the empyema of the anastomotic fistula after esophageal cancer resection. METHODS The clinical data of 624 cases after esophageal cancer and cardia cancer resection from Jan 2000 to Dec 2006 were analyzed retrospectively which included 14 cases of the empyema of the anastomotic fistula. RESULTS All the cases were treated with the closed thoracic drainage, in which 9 cases were cured with closing double-tube chest douching technique, 3 cases were succeeded to operate secondary thoracotomy for anastomosis, 1 case died after being sent to the higher grade hospital, 1 case died for toxic shock and respiratory failure without the chance of reoperation. CONCLUSIONS The key measures of prevention of empyema of post-operative esophagogastrostomy anastomotic fistula inside thorax are strictly distincting between indication and contraindication, carefully preparating before operation, commanding operative time and technical skill, strengthening nursing management, and fulfilling the oral manipulation and nursing prcedures about the drainage tube after operation.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2008年第12期1712-1714,共3页
Chinese Journal of Nosocomiology
关键词
食管癌
吻合口瘘
脓胸
预防
Esophagus carcinoma
Anastomotic fistula
Empyema
Prevention
