论文部分内容阅读
例1,男性,48岁。吞咽困难16个月,诊断贲门癌。行胸膜外胸腹联合切口探查;病变位于贲门及胃小弯部,并向胰腺穿孔粘连,向上侵犯食管下端,腹腔及盆腔均有转移。行姑息性切除,弓下食管胃端侧吻合术。术后第7天体温高达39℃以上,脉搏160次,血压10.7/6.67kPa,经“B”超诊断左膈下脓肿。立即于局麻下经腹部原切口进腹,于肝胃之间吸出乳白色脓液约500ml,脓腔行双管引流;口服美蓝发现吻合口瘘,即予禁食,局部加强引流,3天后口服美蓝复查瘘口已闭,术后52天痊愈出院。 例2,男性,49岁。进行性吞咽困难1个月,诊断为食管中段痛。经右胸、腹切口行中段食管癌根治术,于胸膜顶行食管胃吻合及幽门成形术。术后第8天出现高热,呕吐,胃高度扩张,吞少量稀钡发现吻合口瘘,即行胃管减压,但口服美蓝、多次胸穿未找到脓腔。术后第26天始于右腋中线第六肋间发现脓腔,脓液含有美蓝,行
Example 1, male, 48 years old. Difficulty swallowing for 16 months to diagnose cardiac cancer. Thoracic and thoracic combined incision exploration; lesions in the cardia and small stomach, perforation and adhesion to the pancreas, up violation of the lower end of the esophagus, abdominal and pelvic metastasis. Palliative resection, esophagogastric anastomosis under the bow. On the 7th day after the operation, the body temperature was as high as 39°C, the pulse rate was 160, and the blood pressure was 10.7/6.67kPa. After the “B”, the left subphrenic abscess was diagnosed. Immediately under the local anesthesia through the abdomen of the original incision into the abdomen, between the liver and stomach sucked milky pus about 500ml, the abscess cavity double tube drainage; oral methylene blue to find anastomotic leakage, that is, to fasting, local enhanced drainage, 3 days later Oral methylene blue was used to review her fistula and she was discharged after 52 days of surgery. Example 2, male, 49 years old. One month of progressive dysphagia was diagnosed as middle pain in the esophagus. The right thoracic and abdominal incisions were performed for the middle esophageal cancer radical surgery. Esophagogastric anastomosis and pyloroplasty were performed on the top of the pleura. On the 8th day after the operation, high fever, vomiting, and high stomach enlargement were observed. Anastomotic leakage was found after swallowing a small amount of sputum, which was followed by gastric tube decompression. However, oral methylene blue and multiple thoracentems did not find the abscess. On the 26th day after operation, the abscess was found in the sixth intercostal space of the right midline of the right eye. The pus contained methylene blue.