Schwartz H M, Cahow C E, Traube M
Department of Internal Medicine (Gastroenterology Unit, Yale University School of Medicine, New Haven, Connecticut 06510.
Dig Dis Sci. 1993 Aug;38(8):1409-13. doi: 10.1007/BF01308596.
Although esophageal perforation complicates about 5% of pneumatic dilatations performed for achalasia, little is known about associated hospital and long-term courses. In order to assess the outcome of such patients undergoing emergency surgery for repair, records of seven patients sustaining perforation during pneumatic dilatation were compared to those of five patients undergoing elective myotomy during the same period. In perforation patients, mean intervals following the procedure were 3.6 hr to administration of antibiotics and 9.6 hr to surgery. The perforation and elective myotomy groups had similar mean durations of operation (3.8 vs 3.3 hr), intensive care stays (2 vs 1 days) and hospitalization (12 vs 11 days); perforation patients had a significantly longer mean interval from surgery to oral intake (7 vs 5 days). Postdischarge long-term outcomes were alike in the groups. It is concluded that patients with perforation from pneumatic dilatation that is recognized and treated promptly have outcomes that are comparable to those of patients who undergo elective myotomy.
尽管在为贲门失弛缓症进行的气囊扩张术中，食管穿孔的发生率约为5%，但对于相关的住院情况和长期病程却知之甚少。为了评估此类接受急诊手术修复的患者的预后，将7例在气囊扩张术中发生穿孔的患者的记录与同期5例接受择期肌切开术的患者的记录进行了比较。在穿孔患者中，术后至使用抗生素的平均间隔时间为3.6小时，至手术的平均间隔时间为9.6小时。穿孔组和择期肌切开术组的平均手术时长（3.8小时对3.3小时）、重症监护停留时间（2天对1天）和住院时间（12天对11天）相似；穿孔患者从手术到经口进食的平均间隔时间明显更长（7天对5天）。出院后的长期预后在两组中相似。得出的结论是，气囊扩张术导致穿孔且得到及时识别和治疗的患者，其预后与接受择期肌切开术的患者相当。
