78例良性食管穿孔与破裂的临床研究

目的总结分析78例良性食管穿孔与破裂的治疗效果。方法统计2001年12月至2011年6月收治的78例良性食管穿孔和破裂的各种致伤原因,比较可回收覆膜食管支架保守治疗与手术治疗的疗效和死亡率、24h以内手术治疗与24h后手术治疗的疗效和死亡率。结果 19例食管颈部破裂与穿孔均获治愈。59例食管胸部破裂与穿孔,手术治疗的治愈率(78.4%)不优于保守疗法(72.7%),P>0.05。在良性食管穿孔与破裂手术治疗者中,发病后24h内手术者的治愈率77.4%,优于24h后手术者的治愈率45.5%,P<0.05。结论食管颈部破裂与穿孔无论手术修补或应用可回收覆膜食管支架保守治疗,均易治愈,预后较好,且宜24h内治疗。

The clinical research of 78 patients with benign esophageal perforation or rupture

Objective To analyze the experience of 78 patients with benign esophageal perforation or rupture.Methods The clinical data of benign esophageal perforation or rupture in 78 cases who were admitted to our hospital during December,2001and June,2011 were analyzed.The causes resulting in esophageal perforation or rupture were summarized and the outcome of recyclable polyethylene-covered metallic esophageal stent conservative and operative therapy was compared.Meanwhile,the outcome and mortality of operative therapy within or beyond 24 hours were compared.Results 19 patients with esophageal perforation or rupture occurring in the neck were all cured successfully.As for 59 patients with esophageal perforation or rupture in the chest,the curative rate of operative therapy(78.4%) wasn’t better than that of conservative therapy(72.7%)(P>0.05).The curative rate for patients with benign esophageal perforation or rupture undergoing operative therapy within or beyond 24 hours were 77.4% and 45.5%,respectively(P<0.05).Conclusion Both conservative therapy and operative therapy give satisfactory result for esophageal trauma in the neck.The outcome and mortality of operative therapy within 24 hours were greater than that of operative therapy beyond 24 hours for esophageal trauma in the chest.