论文部分内容阅读
目的总结在数字减影血管造影(digital subtraction angiography,DSA)下经鼻-瘘口置入引流管行瘘腔外引流治疗食管癌术后吻合口瘘的方法。方法回顾性分析2007年9月至2011年4月马鞍山市人民医院在DSA下经鼻-瘘口置引流管行瘘腔外引流,同时经鼻置入十二指肠营养管的5例胃食管吻合口瘘患者的临床资料。5例患者均为男性,年龄47～72(60.1±5.7)岁,均已行食管贲门癌根治术,术后发生吻合口瘘,瘘口大小0.7～1.5(1.0±0.3)cm。结果所有患者均成功置管,平均置管时间41.0(30～65)min,置管后经充分引流和营养支持,顺利出院,无1例死亡。随访1～6个月,均能正常饮食,无吞咽困难和饮水呛咳,仅1例伴有轻度食管反流,给予胃动力药和抑酸剂治疗0.5个月后症状消失;无1例出现食管胃吻合口瘢痕性狭窄。结论在DSA下经鼻-瘘口置引流管行瘘腔外引流,同时经鼻置十二指肠营养管行肠内营养,对于治疗食管胃胸内吻合口瘘效果良好,尤其适用于1.5 cm以下的瘘口。该方法创伤小、经济适用,值得临床推荐。
Objective To summarize the method of postoperative esophagogastrostomy fistula drainage by transcatheter fistula drainage with nasal fistula under digital subtraction angiography (DSA). Methods From September 2007 to April 2011, 5 cases of gastroesophageal reflux esophagitis who underwent DSF drainage through the nasal-fistula with drainage tube and nasal duodenal feeding tube were enrolled in Maanshan People’s Hospital from September 2007 to April 2011. Anastomotic leakage in patients with clinical data. All 5 patients were male, ranging in age from 47 to 72 (60.1 ± 5.7) years. All of them were performed radical resection of esophageal and cardiac cancer. Anastomotic fistula occurred after operation. The size of the fistula was 0.7-1.5 (1.0 ± 0.3) cm. Results All the patients were successfully treated. The mean duration of catheterization was 41.0 (30-65) min. After successful drainage, all patients were discharged and no nutritional support was obtained. None of them died. All cases were followed up for 1 to 6 months. All of them had normal diet, no dysphagia and drinking cough. Only 1 patient had mild esophageal reflux. Symptoms disappeared after 0.5 months of treatment with gastric motility drug and antacid; Esophageal anastomotic cicatricial stenosis. Conclusion DSA nasogastric fistula drainage tube drainage through the fistula and enteral nutrition through the nasal duodenal nutrition tube for the treatment of esophageal and stomach anastomotic fistula effect is good, especially for 1.5 cm The following fistula. The method of trauma, affordable, it is clinically recommended.