三种不同引流方式对食管癌术后颈部吻合口瘘引流效果的研究

目的:探讨三种不同引流方式对食管癌术后颈部吻合口瘘的引流效果。方法:收集从2013年1月到2016年9月在我科行食管癌手术并术后发生颈部吻合口瘘患者，比较入组患者所采用的不同颈部引流方式的优劣。结果:共有83例患者纳入研究，有34例进入A组，行纱布条引流组；28例进入B组，行造瘘袋引流组；21例进入C组，行胃管负压引流组。所有入组患者一般资料和手术资料对比无明显统计学差异（P>0.05）。观察指标对比结果显示，C组患者瘘口愈合时间较其他两组时间短［（15.90±4.18）天vs（14.60±4.41）天vs（9.65±3.80）天］，住院时间较其他两组短［（18.10±4.17）天vs（16.20±3.78）天vs（12.30±3.29）天］，换药次数较其他两组少［（37.55±8.75）天vs（14.5±3.23）天vs（10.00±2.05）天］，抗生素使用时间也较其他组明显减少［（13.10±2.49）天vs（10.85±1.84）天vs（7.20±1.74）天］。结论:颈部放置负压引流有助于食管癌术后颈部吻合口瘘愈合，值得临床推广与进一步研究。

The effect of three different drainage methods on cervical anastomotic fistula drainage after esophageal cancer surgery

Objective:To investigate the effect of three different drainage methods for cervical anastomotic leakage after esophageal surgery cancer.Methods:Prospective data of postoperative cervical anastomotic leak patients between January 2013 and September 2016 were collected.Different cervical drainage methods were compared to assess the efficacy of the three drainage methods on healing speed.Results:83 patients were enrolled in the study.34 patients were enrolled in group A:gauze strip drainage.28 patients in group B were enrolled in fistula bag drainage.21 patients in group C were enrolled in negative pressure gastric tube drainage.There was no significant difference in general data and operation data in all groups (P>0.05).The results showed that the time to fistula healing in group C was shorter than that in other groups ［(15.90±4.18)days vs (14.60±4.41)days vs (9.65±3.80)days］.The hospitalization time was shorter than that in other groups ［(18.10±4.17)days vs (16.20±3.78)days vs (12.30±3.29)days］.The frequency of dressing change was less than that in other groups ［(37.55±8.75)days vs (14.5±3.23)days vs (10.00±2.05)days］.The time patient on antibiotic was also significantly reduced compared with other groups ［(13.10±2.49)days vs (10.85±1.84)days vs (7.20±1.74)days］.Conclusion:Negative pressure drainage with GI tube in the neck is helpful to the healing of cervical anastomotic leak after esophageal cancer surgery.This is worthy of clinical promotion and further investigation.