摘要
目的：通过回顾性分析食管闭锁并气管食管瘘患儿的临床资料,了解食管闭锁术后吻合口狭窄的的发生率、其可能的相关因素及食管扩张对吻合口狭窄的治疗意义。方法回顾性分析我院1994年1月至2013年12月进行手术的155例先天性食管闭锁并气管食管瘘患儿的临床资料。结果17例患儿出现食管吻合口狭窄（ⅢA型4例,ⅢB型13例）,食管吻合口狭窄发生率11.0%,56例食管吻合口瘘,发生率36.1%（ⅢA型17例,ⅢB 型39例）。经卡方检验,食管吻合口漏的患儿与无漏患儿在食管狭窄的发生上差别有统计学意义,但吻合口漏、吻合口狭窄的发生在不同分型间差异无统计学意义。17例患儿进行食管扩张频次共计63次,平均扩张次数为3.71次/人。结论食管闭锁并气管食管瘘的患儿出现吻合口狭窄与食管盲端与远端瘘管间的距离无关。术后食管吻合口瘘患儿更容易出现吻合口狭窄（P=0.009）。食管吻合口狭窄可通过食管扩张缓解。
Objective To identify the risk factors of anastomotic strictures （AS ） after esophageal atresia （EA）repair and explore the efficacies of esophageal dilatations for AS.Methods Retrospective analyses were performed for the data of 155 EA patients with trachoesophageal fistula （Gross type Ⅲ）patients undergoing esophageal anastomosis at our institution between January 1994 and December 2013.Results A total of 17 cases developed AS （type A,n=4;type B,n=13）.The AS rate was 1 1 .0% and anastomotic leak rate 36.1%.By chi-square test,the difference of those with anastomotic stricture with or without leakage was statistically significant.No statistical differences existed in anastomotic leak or stricture between different classifications.Sixty-three dilation sessions were performed with an average of 3.71 （1-10）sessions per patient.Conclusions The distance between proximal blind pouch and distal fistula has no correlation with an elevated risk of AS.Patients of an anastomotic leak have an elevated risk of developing AS （P=0.009）.Stricture may be managed by subsequent esophageal dilatations.
出处
《中华小儿外科杂志》
CSCD
北大核心
2014年第8期569-571,共3页
Chinese Journal of Pediatric Surgery
关键词
食管闭锁
扩张
吻合口狭窄
Esophageal atresia Dilatation Anastomotic stricture
