22例自发性食管破裂的诊断和外科治疗

目的：总结自发性食管破裂诊断和外科治疗的经验,方法：对我国1966－1998年治疗的22例自发性禽管破裂病例的诊断,治疗,结果进行回顾性分析。结果：本组病例10例在48h内确诊并手术,死亡率为20％（2／10）,超过48h的12例,死亡率为41．7％（5／12）,行一期修补术的9例中有5例距发病超过24h, 成功3例,结论：早期诊断和选择合理术式进行治疗是提高本病疗效,降低死亡率的关键,24h不是能否行一期修补术的时间界限。

Diagnosis and surgical treatment of 22 cases with spontaneous rupture of esophagus

Objective To summarize the experiments of diagnosis and surgical treatment of spontaneous rupture of esophagus (Boeahavve Syndrome).Methods To review and analyze the diagnosis?treatments and results of 22 patients of spontaneous rupture of esophagus treated in our hospital in the year 1966~1998.Results Early diagnosis and operation were performed on 10 cases(<48h) of the group and the mortality rate was 20%(2/10), the other 12 cases treated lately ,the mortality rate was 41.7% (5/12). 5 cases of the patients admitted primary repair after 24h, 3 were successful.Conclusion Early diagnosis and appropriate surgical treatments are the key to increase the curative effect and reduce the mortality rate.24h is not the demarcation line to determine whether primary repair should be done. Primary repair is the first choice if the condition of horizontal tear and thoracic cavity permit.