新生儿食道闭锁术后并发症与生存率─—13年病例回顾

目的总结和讨论食道闭锁术后并发症的防治，以提高食道闭锁术后存活率。方法总结13年间29例先天性食道闭锁病例手术成活率的经验，分析并发症与存活率的关系。结果19例Ⅰ期食管气管疾管结扎切断、食管端端吻合，1例外院术后发生吻合口瘘转入的20例中15例获得痊愈（75％），而1984～1990年间Ⅰ期手术治愈率为6／10（60％），1991～1996年则提高为9／10（90％）。1996年度手术7例全部存活，其中2倒闭锁远近端食道距离大于2cm。结论加强术前术后的管理，积极有效的预防和治疗术后并发症是提高食道闭锁患儿存活率的关键。

Survival rate and complications of postoperation in infant with esophageal atresia

Objective To investigate prevention and treatment of the complictions of postopera-tion and to raise the rate of survival in infant with esophageal atresia. Methods Sum up the experience of the raise of survival in the infants with esophageal atresia after operation in past 13 years. Analysis the relationship between postoperation complictions and the rate of survival. Results l9 cases were performed primary anastomosis, one was admitted, who was complicating the anastomotic leakage after operation in other hospital. 15 (75%) cases are cured in past 13 years. During 1984 to 1990, the cure rate of primary anastomosis is 6/10(60% ). From 1991 to 1996, it is 9/10(90%). In 1996, it is 7/7 (100% ), including 2 cases of long-gap esophageal atresia. Conclusion The key of the raise of the rate of postoperative survival in infant with esophageal atresia is the right management during preoperation and active prevention and treatment of postoperative complications.