摘要
目的探讨Ш型食管闭锁的早期诊断与治疗方法。方法回顾性分析我院2006年08月～2008年07月收治的16例Ш型食管闭锁患儿的临床资料。所有病例均经造影证实,采用经胸膜外入路行食管气管瘘结扎切断、食管端端吻合术,部分病例加行Livaditis法环切食管肌层,延长食管减小张力后再行食管端端吻合。结果16例均行手术治疗,全部治愈。1例术后吻合口瘘行二次修补手术后治愈出院;1例术后吻合口瘘,经抗感染、营养支持、充分引流后瘘口愈合。术后随访6个月～2年,其中术后吻合口瘘保守治疗治愈者1年后并发肺部感染死亡,余11例进食良好。结论早期诊断、及时手术、术后护理及并发症的防治对提高先天性食管闭锁患儿的存活率有重要作用。尤其减少吻合口张力对防止吻合口瘘起决定性作用。术中避免胸膜破裂对呼吸功能的恢复和预后起重要作用。早期拔除放置于吻合口旁的胸膜外引流管有利于吻合口的愈合。
Objective To investigate the early diagnosis and therapy of Type Ⅲ Congenital Esophageal Atresia（CEA）. Method A retrospective analysis had been adopted to the clinical materials of 16 cases of type Ⅲ CEA during August 2006 to July 2008 in our hospital. All cases had been confirmed by angiography. The Tracheoesophageal Fistula （TF） through outerpleura path were ligated and the anastomosis operation was done. Some cases were added the procedure of Lovaditis for cutting the t.muscularis oesophagi before the anastomosis opertation. Results All 16 cases had been done the surgery and all were cured. Among all the cases, one was conducted a repair operations before fully cured, one was fully cured after anti-infection, nutrition support and fully postoperative drainage. All cases were tracked for 6 months to 2 years. One case died for the infection of lung and the other 11 cases had been in good condition. Conclusion Early diagonosis, prompt surgery, good postoperative nursing and the preventive and therapy of complication were of great importance in improving the survival rate of CEA. In particular, the reducing ofanastomotic had decisive effect to anastomotic leakage. The avoidance of pleura rupture was significant for the recovery and prognosis. The early extraction of the pipe of outer pleural of the postoperative drainage near the anstomosis was beneficial for the recovery of the anastomosis.
出处
《临床医学工程》
2009年第7期63-64,共2页
Clinical Medicine & Engineering
关键词
食管闭锁
诊断
治疗
Esophageal Atresia
Diagnosis
Treatment
