肠道准备致食管破裂一例报告并文献复习

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目的:总结肠道准备致食管破裂的临床特点及诊治方法,提高对该病的认识。方法:结合皖南医学院弋矶山医院2020年1月收治的肠道准备致食管破裂患者1例的临床资料,以食管破裂为关键词检索中国知网数据库中2009-2019年的相关文献报道,进行分析总结。结果:该例患者因行内镜黏膜下剥离术治疗,应用硫酸镁行肠道准备后剧烈呕吐致食管破裂,经内镜下钛夹治疗及胸腔闭式引流等治疗措施治愈。检索文献89篇共929例食管破裂病例,男性多于女性,发生率自发性>异物性>外伤性>医源性,手术病例数(736例)>非手术病例数(193例),治愈率(86.65%)高于病死率(13.35%)。结论:食管破裂是临床较少的急症之一,临床症状不典型,详尽的询问病史、及时有效的影像学检查才能早确诊早治疗,从而降低该病的病死率,改善该病患者的预后。“,”Objective:To summarize the clinical characteristics, diagnosis and treatment of esophageal rupture caused by intestinal preparation, in order to improve the understanding of this disease.Methods:We combined with the clinical data of one patient with esophageal rupture caused by intestinal preparation admitted to Yijishan Hospital of Wannan Medical College in January 2020, and reviewed the relevant literature reports from 2009 to 2019 in CNKI database with esophageal rupture as the key word.Results:The patient suffered from esophageal rupture due to severe vomiting after magnesium sulfate enema preparing for endoscopic submucosal dissection.The patient was cured by endoscopic titanium clip therapy and closed thoracic drainage.A total of 89 articles involving 929 cases of esophageal rupture were retrieved, and it was found that males were more than females, the incidence of spontaneous>foreignness>traumatic>iatrogenic, the number of surgical cases(736 cases) was more than that of non-surgical cases(193 cases), the cure rate(86.65%) was higher than the death rate(13.35%).Conclusion:Esophageal rupture is one of the clinical emergencies with atypical clinical symptoms.Only detailed medical history inquiry and timely, effective imaging examination can make early diagnosis and early treatment, so as to reduce the fatality rate of the disease and improve the prognosis of patients with the disease.
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