自发性食管破裂临床分析--附18例报告

目的：探讨自发性食管破裂的早期诊断与治疗的必要性。方法：自1986年8月～2001年6月，18例自发性食管破裂病人接受外科治疗，开胸手术裂口修补5例；食管切除、食管胃胸膜顶吻合2例；裂口修补加胃造瘘3例；单纯胸腔闭式引流加空肠造瘘8例。结果：开胸手术10例，死亡1例，平均住院25d。保守治疗8例，死亡5例，死亡率(5／8)62．5％，平均住院45d。结论：自发性食管破裂早期诊断是治疗的关键，一旦诊断明确应积极开胸手术，即使发病超过24h，只要全身条件允许也应积极手术治疗。食管切除，食管胃吻合，较其它术式更为安全。

Clinical Analysis of Spontaneous Esophagus Perforation (with 18 Cases Report)

Objective: To investigate the early diagnosis and treatment of spontaneous esophagus perforation. Methods: From August 1986 to June 2001,18 patients with spontaneous esophageal perforation accepted surgical treatment.Open chest and esophagus repair in 5 patients;esophageal resection and esophagealogastrostomy in 2 patients; Repair and gastrostomy in 3; single chest tube drainage and jejunostomy in 8. Results: Among 10 patients performed open chest operation, 1 died.the average hospitalization period was 25 days. However, 5 out of 8 patients accepted conservative treatment died,motality rate was (5/8) 62.5%. the average hospitalization period was 45 days. Conclusion: Early diagnosis is the key to treatment of spontaneous esophagus perforation.Once diagnosed,open chest operation should be performed immediately. As long as general situation allows, even if exceed 24 hours,operation can be considered. Esophagus resection and esophagealogastrostomy is rather safe.