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[良性食管气管支气管瘘的诊断与治疗:附26例报告]

[The diagnosis and treatment of benign esophagotracheo-bronchial fistula: a report of 26 cases].

作者信息

Gao C, Huang O, Gu K

机构信息

Shanghai Chest Hospital.

出版信息

Zhonghua Wai Ke Za Zhi. 1995 Feb;33(2):71-2.

PMID:7656706
Abstract

Twenty six patients with esophagotracheal fistula or esophagobronchial fistula were treated from 1960 to 1991. There were 18 males and 8 females with age ranging from 19 to 69. Trauma and complication of esophageal diverticulum were the main causes of fistula. Among 23 patients surgically treated, 10 underwent direct repair, and 13 either closure of esophageal defect or tracheal or bronchial defect. The concomitant procedures were permanent tracheostomy, tracheal resection and reconstruction, pulmonary resection, thoracoplasty esophagectomy, and esophagogastric anastomosis. All patients resumed normal eating. Complications included paralysis of recurrent nerves, empyema, injury and ligation of subclavian artery, dehiscence of tracheal anastomosis, and contralateral pneumohydrothorax in each patient. Prognosis of 3 nonsurgical treatments of fistulas was poor. Surgical intervention should be done as soon as the diagnosis is established in order to minimize pulmonary complication.

摘要

1960年至1991年期间,对26例食管气管瘘或食管支气管瘘患者进行了治疗。其中男性18例,女性8例,年龄在19岁至69岁之间。创伤和食管憩室并发症是瘘管的主要原因。在23例接受手术治疗的患者中,10例行直接修复,13例行食管缺损或气管或支气管缺损闭合术。同期手术包括永久性气管造口术、气管切除重建术、肺切除术、胸廓成形术、食管切除术以及食管胃吻合术。所有患者均恢复了正常饮食。并发症包括喉返神经麻痹、脓胸、锁骨下动脉损伤及结扎、气管吻合口裂开以及对侧液气胸。3例非手术治疗瘘管的患者预后较差。一旦确诊,应尽快进行手术干预,以尽量减少肺部并发症。

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