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目的:总结Ⅰ期手术修补治疗晚期自发性食管破裂的经验。方法:回顾性分析山西医科大学附属阳泉市第一人民医院2003年12月—2013年12月13例晚期自发性食管破裂患者的手术疗效。13例均为男性;年龄(52.4±12.8)岁;发病至手术时间(72.3±24.5)h。所有患者行脓胸廓清+纤维板剥脱+Ⅰ期食管修补。结果:13例患者均治愈。Ⅰ期愈合6例(46.15%),术后瘘7例(53.85%)。1例术后合并呼吸功能不全,1例术后切口感染,经保守治疗痊愈。结论:晚期自发性食管破裂彻底清创后Ⅰ期修补是可行的,手术愈后良好。
Objective: To summarize the experience of stage Ⅰ surgical repair in the treatment of advanced spontaneous esophageal rupture. Methods: A retrospective analysis was performed on 13 cases of advanced spontaneous esophageal rupture in the First People’s Hospital of Yangquan, Shanxi Medical University from December 2003 to December 2013. Thirteen patients were male; age (52.4 ± 12.8) years; onset to operation time (72.3 ± 24.5) h. All patients underwent empyema clearance + fibrotic exfoliation + stage I esophageal repair. Results: All 13 patients were cured. Six cases (46.15%) were healed in stage Ⅰ and 7 cases (53.85%) were postoperative fistula. One case of postoperative respiratory insufficiency, one case of incision infection, cured by conservative treatment. Conclusions: The stage Ⅰ repair after radical debridement of advanced spontaneous esophageal rupture is feasible and the prognosis is good after operation.