摘要
恶性食管瘘是一类由各种原因导致食管与周围组织产生异常通道的恶性疾病,常见于食管癌或肺癌,极少数发生于下咽部或纵隔。根据瘘口所连接的部位不同,可分为食管气管瘘、食管纵隔瘘、食管胃吻合口瘘、食管肠吻合口瘘、食管胸腔瘘及食管主动脉瘘等。恶性食管瘘一旦发生,患者通常由于吸入性肺炎、纵隔脓肿及营养不良等导致全身多器官功能衰竭,死亡率极高。目前对于恶性食管瘘的治疗尚无共识,主要的治疗方式包括营养支持治疗、微创治疗、手术治疗。但食管瘘的位置、大小和外观在不同的患者中可能有很大的不同,针对不同类型的食管瘘患者选择最佳的治疗方式就显得尤为重要。本文就恶性食管瘘的发病机制、诊断标准、治疗方法作一综述,以期为临床治疗恶性食管瘘提供参考依据。
Malignant esophageal fistula is a type of malignant disease that results in abnormal passage between the esophagus and the surrounding tissues due to various causes.It is commonly due to esophageal or lung cancer,and rarely due to hypopharyngeal or mediastinum malignancies.Depending on the site to which the fistula is attached,it can be classified as esophagotracheal fistula,esophageal mediastinal fistula,esophagogastric anastomotic fistula,esophagogastric anastomotic fistula,esophagothoracic fistula and esophageal aortic fistula.Once malignant esophageal fistula occurs,the patient usually suffers from systemic multi-organ failure due to uncontrollable aspiration pneumonia,mediastinal abscess and malnutrition,and the mortality rate is extremely high.There is no consensus on the treatment of malignant esophageal fistulas,and the main treatment modalities include nutritional support therapy,minimally invasive therapy,and surgery.However,the location,size,and appearance of esophageal fistulas may vary greatly from patient to patient,and it is particularly important to choose the best treatment modality for patients with different types of esophageal fistulas.This article reviews the pathogenesis,diagnostic criteria and treatment of malignant esophageal fistula,in order to provide reference for clinical treatment of malignant esophageal fistula.
作者
孟雪
吴婷婷
肖毓
谭榜宪
MENG Xue;WU Ting-ting;XIAO Yu;TAN Bang-xian(Department of Oncology,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China)
出处
《医学信息》
2022年第2期43-46,共4页
Journal of Medical Information
关键词
恶性食管瘘
营养支持治疗
微创治疗
手术治疗
Malignant esophageal fistula
Nutritional support therapy
Minimally invasive therapy
Surgery therapy
作者简介
孟雪(1996.9-),女,四川邻水县人,硕士研究生,主要从事胸部肿瘤的研究;通讯作者:谭榜宪(1964.11-),男,四川三台县人,硕士,硕士生导师,主要从事以放射治疗为主的肿瘤综合治疗工作。
