食管贲门癌术后胸腔积液的防治体会：附26例分析

本文报告手术治疗食管贲门癌1512例,术后发生胸腔积液26例,发生率1.7％。作者指出,预防本症发生的关键措施。1.术中仔细操作,防止过多损伤。2.引流管必须定时检查,保证引流通畅。3.术后24小时必须改半卧位,有利胸液排出。4.术后48小时拔管较为安全。胸部X线检查即可确诊,如积液较多,可根据胸部X线正侧位片及超声波检查定位,作胸膜穿刺抽液。大多数病人胸穿1～2次即可治愈,如胸液仍多,也可重新安放胸腔闭式引流管。

Prevention and Treatment of Pleural Effusion following Resection of Esophageal and Gastric Cardiac Cancer.A Report of 26 Cases

Of 1512 cases of esophageal and gastric cardiac cancer resected, 26 developed post- operative pleural effusion (1.7%). The critical measures suggested for preventing this complication consist of (1) meticulous operative handling with least damage to major vessels and lymphatics, (2) pay special attention to drainage tube ensuring its patency, (3) patient should be placed in semi-Fowler's position for 24 hrs after oper- ation and be patted on the back and encouraged to cough and take deep breaths (4) drainage tube be removed at 48 hours after operation. Diagnosis of pleural effusion can be confirmed by fluoroscopy. In case of profuse effusion further A-P view and profile X-ray films as well as ultrasonic examination should be taken. Most of our patients were cured by one or two thoracentesis. A second time drainage may be done when needed.