13例自发性食管破裂的诊断和治疗

目的:总结自发性食管破裂(Boerhaave′s Syndrome)诊断和治疗的经验。方法:结合文献对我们所治疗的13例自发性食管破裂病例的诊断、治疗、结果进行回顾性分析。结果:本组病例9例在48 h内确诊并手术,4例经手术探查确诊。本组病死率为46%(6/13)。行一期修补术的8例中有5例距发病超过24 h,成功3例。结论:高度警惕本病并迅速获得全面、准确的发病史是避免误诊、漏诊的关键。诊断主要根据胸片、食管造影及特征性的胸腔引流物。早期诊断和选择合理术式进行治疗是提高本病疗效,降低病死率的关键。

Diagnosis and treatment of spontaneous rupture of esophagus in 13 cases

Objective:To summarize the experience of diagnosis and treatment of spontaneous rupture of esophagus(Boerhaave′s Syndrome).Methods: The diagnosis,treatment and results of 13 patients with spontaneous rupture of esophagus treated in our hospital were analyzed retrospectively by reviewing the involved literature.Results: 9 out of the 13 cases received early diagnosis and underwent operation within 48 hours,and another 4 were confirmed intraoperatively.The mortality rate was 46 %(6/13).In 8 cases of the patients admitted primary repair,only 3 cases were cured,another 5 failed due to going through over 24 h.Conclusion:Prompt diagnosis and interview are important to this disease.The diagnosis can be confirmed or excluded by a chest film,esophagogram or specific contents in thoracic fluid.Early diagnosis and appropriate surgical treatment are likely to reduce the mortality rate.