损伤性食管穿孔的诊断和治疗(附38例报告)

1966年2月至1993年8月治疗38例损伤性食管穿孔。损伤性食管穿孔以食管异物引起为最多见,共23例,占60.5％;其次为外伤性8例,器械性和手术误伤7例。行食管修补术12例,11例成功(91.7％);18例行颈部、纵隔或胸腔引流术;8例保守治疗。38例中痊愈29例,治愈率76.3％;死亡9例(23.7％)。作者认为早期诊断和及时处理对提高治愈率至关重要,应根据发病时间、病情程度选择不同的治疗措施。

Diagnosis and Treatment of Traumatic Perforation of the Esophagus. Report of 38 Cases

Traumatic perforation of the esophagus is relatively uncommon, but it is usually associated with high mortality even if the perforation is surgically repaired in the early stage. This article presents the diagnosis and treatment of traumatic perforation of the esophagus in 38 patients from Feb, 1966 to Aug, 1993. The perforation was caused by foreign bodies in 23(60.5%), trauma in 8(21%) and iatrogenesis in 7 (18.4%). In 12 patients, the perforation of the esophagus was surgically repaired successfully in 11 cases(91.7%). In 18 late cases, only surgical drainage was instituted and in another 8 cases conservative measures were adopted. The over-all survival rate in this group of patients was 76.3% (29/38) and mortality rate was 23.7%(9/38). The authors emphasize that early diagnosis and timely management are the most important factors for increasing the survival rate. The type of treatment should be chosen according to the duration of perforation, presence or absence of complicaions and patients's general condition.