“综合引流法”治疗胸内食管胃吻合口瘘合并包裹性脓胸

目的探索综合引流治疗胸内食管胃吻合口瘘合并包裹性脓胸的价值。方法对2000年1月～2011年6月手术切除的食管癌、贲门癌中发生胸内食管胃吻合口瘘合并包裹性脓胸的4例临床资料进行回顾性分析。其中合并脓胸3例采用综合引流法即:用胃管引流胃液,胸腔闭式引流胸腔积液,介入方法置引流管引流瘘腔,胸壁置细引流管(中心静脉导管)负压引流包裹性积液,B超定位胸穿随时抽吸新发包裹性积液。结果 25d左右纵隔脓腔消失,各引流管及肠造瘘肠内营养管先后拔出,患者可顺利进食。结论综合引流治疗胸内食管胃吻合口瘘合并脓胸安全、经济、有效。

Method of treating Pyothorax due to postoperative anastomotic leakage in esophageal and gastric cancer by comprehensive drainage

Objective To investigate the value of treating encapsulated Pyothorax due to postoperative anastomotic leakage in esophageal and cardiac cancer by comprehensive drainage.Methods The date of 4 cases of encapsulated Pyothorax due to postoperative anastomotic leakage in esophageal and cardiac cancer during January,2000 to June,2011 were analyzed retrospectively.Three Patients with pyothorax were treating by comprehensive drainage.The gastric juice was drained through gastric tube;the pleural effusion was drained through closed thoracic cavity.The liquor puris was drained by inserting drainage tube with interventional method.The encapsulated fluid was drained through negative pressure by setting cvc and the new fluid could be suited by chest puncture under B-Position at any time.Results The drainage tubes and the internal nutrition tube could be pulled out relatively.About 25days with disappearances of the abscess cavities and the patients could intake normal diet without difficulty.Conclusions The method of treating Pyothorax due to postoperative anastomotic leakage in esophageal and cardiac cancer is safe,economic and effective.