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目的研究纵隔引流管在食管癌术后吻合口瘘防治中的应用价值。方法 2012-03-2015-10我科共行颈胸腹三切口食管癌根治术的患者668例。男426例,女242例,年龄41~72岁,平均年龄(56.5±6.9)岁,术中留置纵隔引流管和胸腔闭式引流管360例(研究组),单纯留置胸腔闭式引流管308例(对照组)。对照组采取常规治疗方法进行,研究组则通过对纵纵隔引流管执行,对比两组患者发生吻合口瘘症状的实际效果。结果在执行相应的临床分析后,患者的基本症状都得到了极大的改善,而研究组的临床效果,相比较对照组,其临床恢复情况优于对照组,而患者在基本的临床治疗中,通过基本的病症分析,其中研究组患者死亡病例1例,对照组死亡4例,吻合口瘘发生率研究组发生6例,对照组14例,其他并发症状结果经比较,也具有较大差异,经分析两组患者的基本症状合并差异有统计学意义,P<0.05。结论在临床中食管癌术后的吻合口瘘的解决问题上,通过预置纵隔引流管,可以有效的防治吻合口瘘,达到有效的临床治疗,得到一个较好的处理效果,从而实现了对患者在感染症状的上的改良处理,并依照相应的试验标准,缩短患者的住院时间,降低死亡率,可在临床中进行推广应用。
Objective To study the value of mediastinal drainage tube in the prevention and treatment of anastomotic leakage after esophagectomy. Methods 2012-03-2015-10 668 cases of common cervico-thoracotomy and triple-incision esophagectomy in our department. There were 426 males and 242 females, aged 41-72 years (mean age 56.5 ± 6.9 years). 360 patients had a mediastinal drainage tube and thoracic closed drainage tube (study group), a simple indwelling thoracic closed drainage tube 308 Example (control group). The control group was treated by conventional treatment, while the study group performed the longitudinal mediastinal drainage tube to compare the actual effect of anastomotic leakage symptoms in the two groups. Results After the corresponding clinical analysis, the basic symptoms of patients have been greatly improved, while the study group’s clinical effect, compared with the control group, the clinical recovery was better than the control group, and patients in the basic clinical treatment , Through the basic analysis of the disease, including 1 case of death in the study group, 4 cases of death in the control group, the incidence of anastomotic fistula occurred in 6 cases in the study group, 14 cases in the control group, the other complications were compared with the results also have significant differences , The analysis of the two groups of patients with the basic symptoms merged difference was statistically significant, P <0.05. Conclusion In the clinical treatment of esophageal anastomotic leakage after esophageal fistula, through the preset mediastinal drainage tube, can effectively prevent anastomotic fistula, to achieve effective clinical treatment, get a better treatment effect, so as to achieve a Patients in the improvement of the symptoms of infection and treatment, and in accordance with the appropriate test standards, shorten the hospital stay of patients, reduce mortality, can be popularized in clinical applications.