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目的探讨食管癌贲门癌手术切除后并发吻合口瘘的发生原因、致死因素及有效治疗措施。方法对手术切除食管癌贲门癌10860例进行回顾性分析,总结术后并发吻合口瘘的发生因素、临床表现、诊断与治疗体会。结果术后确诊并发吻合口瘘148例,除1例继发双肺感染及切口感染致感染性休克及多脏器功能衰竭死亡,余147例经治疗痊愈,死亡率0.68%。结论①吻合方式及操作技巧是术后吻合口瘘发生的主要因素之一;②感染和营养不良衰竭是主要死亡原因;③三管(胸管、胃管、营养管)畅通是治疗的关键所在。
Objective To investigate the causes of postoperative anastomotic fistula after esophagectomy and cardia cancer resection and the lethal factors and effective treatment measures. Methods 10860 cases of esophageal and gastric cardia carcinoma resected retrospectively were analyzed retrospectively. The occurrence factors, clinical manifestations, diagnosis and treatment of anastomotic fistula were summarized. Results A total of 148 cases of anastomotic fistula were diagnosed after operation, except for one case of septic shock and multiple organ failure caused by secondary infection of the lung and incision infection. The remaining 147 cases were cured and the mortality rate was 0.68%. Conclusions ① Anastomosis and operation skills are one of the main causes of postoperative anastomotic fistula. ②Infections and malnutrition failure are the main causes of death. ③Three tubes (chest tube, gastric tube and nutrition tube) are the key to treatment .