摘要
目的 分析食管癌术后并发消化道-呼吸道瘘的原因,总结其诊断、治疗、预防的方法。方法 回顾性分析2010年12月至2020年12月我院胸外科行手术治疗同时并发消化道-呼吸道瘘的食管患者临床特征、治疗手段和预后状态。结果 共收集32例消化道-呼吸道瘘,其中30例与消化道瘘相关,2例为气管切开时的机械损伤。32例中,14例瘘口愈合,平均愈合时间(3.15±1.90)个月。32例中24例经保守治疗,9例愈合;6例行支架封堵,4例愈合;2例行手术治疗,1例愈合;患者1年内死亡率为50%,中位生存时间为(9.50±2.14)个月。结论 术中气管损伤、术后气管插管、长时间机械通气、消化道瘘等是发生消化道-呼吸道瘘的重要原因;患者早期死亡原因为肺部感染与呼吸衰竭,晚期死亡原因主要为肿瘤复发;食管或气管支架可能在消化道-呼吸道瘘的治疗中更具有优势。
Objective To analyze the causes of digestive-respiratory tract fistula after esophagectomy,and summarize the methods of diagnosis,treatment and prevention.Methods The clinical characteristics,treatment methods and prognosis of esophageal patients with digestive-respiratory tract fistula who underwent surgical treatment in our hospital from December 2010 to December 2020 were retrospectively analyzed.Results Of the 32 cases collected,30 cases of digestive-respiratory tract fistula were related to gastrointestinal fistula,and 2 cases were mechanical injury during tracheotomy.14 cases were healed with an average healing time of(3.15±1.90)months.24 were treated conservatively and 9 were cured;6 cases underwent stent occlusion and 4 cases healed;2 cases were treated by operation,and 1 case healed.The one-year mortality rate was 50%and the median survival time was(9.50±2.14)months.Conclusion Intraoperative tracheal injury,postoperative tracheal intubation,long-term mechanical ventilation,and gastrointestinal fistula are important factors for digestive-respiratory tract fistula.The early death causes are pulmonary infection and respiratory failure,and the late death causes are tumor recurrence.Esophageal or tracheal stents may be more advantageous in the treatment of digestive-respiratory tract fistula.
作者
向宗骏
万志渝
鲁勇国
张帆
牟海德
李晓明
黄静
Xiang Zongjun;Wan Zhiyu;Lu Yongguo(Department of Thoracic Surgery,Guangyuan Central Hospital,Guangyuan,Sichuan 628000,China)
出处
《四川医学》
CAS
2023年第7期733-737,共5页
Sichuan Medical Journal
关键词
消化道-呼吸道瘘
食管癌
食管切除术
digestive-respiratory tract fistula
esophagus carcinoma
esophagectomy
