摘要
目的探讨术中放置纵隔引流管对食管癌根治术后吻合口瘘的治疗作用。方法择取2017年1月-2019年10月本院收治的食管癌患者108例,按随机数表法分为两组,各54例。两组均接受术前新辅助放化疗(neo CRT),并于neo CRT治疗结束3-4周后,行胸腹腔镜联合食管癌切除术。对照组术后单纯放置胸腔引流管,观察组同时留置胸腔引流管与纵隔引流管。比较两组术后吻合口瘘、肺部感染、心率失常等并发症发生及引流情况,统计两组吻合口瘘者的确诊时间、白细胞计数、体温及术后住院时间。结果两组吻合口瘘发生率比较,差异无统计学意义(P>0.05);观察组肺部感染、心律失常发生率低于对照组,差异有统计学意义(P<0.05)。观察组吻合口瘘患者的确诊时间、术后住院时间短于对照组,WBC计数、体温低于对照组,差异有统计学意义(P<0.05);两组胸管拔除时间比较,差异无统计学意义(P>0.05);观察组胸管引流量少于对照组,胸腔引流总量大于对照组,差异有统计学意义(P<0.05)。术后无脑脊液鼻漏及视野缺损等并发症的发生,无1例死亡。结论neo CRT治疗后行食管癌根治术的患者术中放置纵隔引流管可充分引流、控制纵隔感染,有助于早期发现吻合口瘘的发生,缩短住院时间,避免二次开胸手术,减少心肺并发症,值得推广。
Objective To investigate the therapeutic effect of mediastinal drainage tube on anastomotic fistula after radical resection of esophageal cancer.Methods 108 patients with esophageal cancer who underwent thoracoscopy combined with esophagectomy in our hospital from January 2017 to October 2019 were selected and divided into two groups according to random number table method,54 cases each.The thoracic drainage tube was simply placed in the control group after operation,while the thoracic drainage tube and mediastinal drainage tube were kept in the observation group at the same time.The complications and drainage of anastomotic fistula,pulmonary infection,arrhythmia and other complications were compared between the two groups,and the diagnosis time,white blood cell count,body temperature and postoperative hospital stay of the two groups were compared.Results There was no significant difference in the incidence of anastomotic fistula between the two groups(P>0.05).The incidence of pulmonary infection and arrhythmia in the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).The diagnosis time and postoperative hospital stay of the patients with anastomotic fistula in the observation group were shorter than that of the control group.The WBC count and body temperature were lower than that of the control group,and the differences were statistically significant(P<0.05).There was no difference in the comparison of the chest tube removal time between the two groups.The significance was statistically significant(P>0.05).The thoracic drainage volume in the observation group was less than that of the control group,and the total thoracic drainage volume was greater than that of the control group.The difference was statistically significant(P<0.05).Conclusion The placement of mediastinal drainage tube during radical operation for esophageal cancer patients can fully drain and control mediastinal infections,which help to detect the occurrence of anastomotic fistula early,shorten the length of hospital stay,avoid secondary thoracotomy,and reduce cardiopulmonary complications,which is worth promoting.
作者
曾高云
张利民
李超
王跃华
王玮瑾
ZENG Gaoyun;ZHANG Limin;LI Chao;WANG Yuehua;WANG Weijin(The Second Department of General Surgery,Korla hospital of the Second Division of Xinjiang Production and Construction Corps,Korla,Xinjiang 841000,China;The Fifth Surgical Ward,Shandong Cancer Hospital,Jinan,250000,China)
出处
《新疆医学》
2020年第7期666-669,共4页
Xinjiang Medical Journal
基金
新疆生产建设兵团第二师铁门关市社会发展科技攻关项目(项目编号:2018SFGG01)
关键词
食管癌根治术
新辅助放化疗
胸腹腔镜联合食管癌切除术
纵隔引流管
吻合口瘘
并发症
Radical Esophagectomy
Neoadjuvant Chemoradiotherapy
Thoracoscopic Combined with Esophageal Cancer Resection
Mediastinal Drainage Tube
Anastomotic Leakage
Complications
作者简介
曾高云,男,副主任医师,研究方向:临床普通外科,创伤。
