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目的:探讨食管癌术中在食管床放置纵隔引流管对患者术后并发症尤其是吻合口瘘的临床治疗作用。方法:回顾分析420例食管癌手术患者,按照术中是否放置了纵隔引流管分为试验组和对照组,其中试验组220例放置了纵隔引流管、对照组200例未放置纵隔引流管,观察两组患者吻合口瘘的的发生率、吻合口瘘的确诊时间、瘘发生后的治愈时间及两组患者心肺并发症发生的情况。结果:试验组的吻合口瘘发生率5.5%,对照组吻合口瘘发生率6.0%,两组间吻合口瘘发生率差异无统计学意义,P>0.05;两组患者吻合口瘘的确诊时间差异有统计学意义,P<0.01,其中术中未置纵隔引流管患者的确诊时间要长于试验组患者;观察两组患者瘘的治愈时间,对照组患者所需时间显著多于试验组,两组之间差异有统计学意义,P<0.01;在心肺并发症方面对照组发生的比率显著高于试验组,差异有统计学意义,P<0.05。结论:食管癌术中放置纵隔引流管可以早期发现吻合口瘘的发生,缩短瘘的治愈时间,降低心肺并发症的发生。
Objective: To investigate the clinical effect of placing mediastinal drainage tube in esophageal cancer surgery on postoperative complications, especially anastomotic fistula. Methods: A retrospective analysis of 420 patients with esophageal cancer surgery, according to whether the mediastinal drainage tube placed in the experimental group and control group were divided into two groups, of which 220 cases were placed in the experimental group of mediastinal drainage tube, 200 cases of control group did not place mediastinal drainage tube, observation The incidence of anastomotic fistula, the diagnosis time of anastomotic fistula, the healing time after fistula and the incidence of cardiopulmonary complications in both groups were compared between the two groups. Results: The incidence of anastomotic fistula was 5.5% in the test group and 6.0% in the control group, the incidence of anastomotic fistula was no significant difference between the two groups (P> 0.05). The diagnosis time of anastomotic fistula The difference was statistically significant, P <0.01, of which the diagnosis of patients without drainage catheter drainage was longer than the test group patients; observation of two groups of patients with fistula time to cure, the control group of patients was significantly longer than the test group, two The differences between the two groups were statistically significant (P <0.01). The incidence of cardiopulmonary complications in the control group was significantly higher than that in the experimental group (P <0.05). Conclusion: Placement of mediastinal drainage tube during esophageal cancer surgery can early find the occurrence of anastomotic fistula, shorten the healing time of fistula and reduce the occurrence of cardiopulmonary complications.