上海交通大学学报（医学版）

上海交通大学学报（医学版）

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手术治疗食管自发性破裂的意义

韩丁培1，杭钧彪1，曹子昂2，任 健1，车嘉铭1，陈中元1   

  1. 上海交通大学 医学院 1.附属瑞金医院胸外科， 上海 200025； 2.附属仁济医院胸外科， 上海 200127
  • 出版日期:2014-12-28 发布日期:2014-12-30
  • 通讯作者: 杭钧彪, 电子信箱: hang_jb@163.com。
  • 作者简介:韩丁培（1985—），男，住院医师，硕士; 电子信箱: dmhan1985@163.com。

Significance of surgery in treatment of spontaneous rupture of esophagus

HAN Ding-pei, HANG Jun-biao, CAO Zi-ang, REN Jian, CHE Jia-ming, CHEN Zhong-yuan   

  1. 1.Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; 2.Department of Thoracic Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Online:2014-12-28 Published:2014-12-30

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摘要：

目的 探讨总结手术治疗食管自发性破裂的经验。方法 回顾性分析1993年1月—2012年12月共计21例食管自发性破裂病例资料，包括病因、症状、出现症状至开始治疗时间间隔、治疗方式、转归及住院时间等。结果 患者中男17例，女4例；年龄32～82岁（平均年龄43岁）；出现症状至手术治疗时间间隔＜24 h有9例（42.8%），＜48 h有6例（28.6%），＞72 h有6例（28.6%）；所有患者均接受手术治疗。一期愈合率＜24 h为88.9%，＜48 h为66.7%，＞72 h为0。所有患者均康复出院，平均住院天数＜24 h为18.1 d，＜48 h为27.8 d，＞72 h为51.2 d。结论 手术仍是治疗食管自发性破裂的最佳手段，发病至手术时间越短患者的预后越好，时间间隔已不再是手术与否的评判标准，只要明确诊断，任何时候均有手术机会。

关键词: 食管, 破裂, 治疗, 手术

Abstract:

Objective To explore and summarize the experience of surgical treatment of spontaneous rupture of esophagus. Methods The data of 21 cases of spontaneous rupture of esophagus from January 1993 to December 2012 were retrospectively analyzed, including etiologies, symptoms, time interval between onset and treatment, treatment methods, prognosis, hospital stays, etc. Results There were 17 male patients and 4 female patients. Their age was between 32 and 82 years old (average 43 years old). There were 9 (42.8%), 6 (28.6%), and 6 (28.6%) cases whose time intervals between onset and treat were <24 h, <48 h, and >72 h, respectively. All patients underwent surgical treatment. The primary healing rates were 88.9% (<24 h), 66.7% (<48 h), and 0 (>72 h). All patients were discharged with recovery. The average hospital stays were 18.1 d (<24 h), 27.8 d (<48 h), and 51.2 d (>72 h). Conclusion Surgery was the best way to treat spontaneous rupture of esophagus. The less the time interval between onset and treatment would be with the better the prognosis. The time interval is no longer a judgment standard of surgery. The surgery is indicated if a clear diagnosis can be made.

Key words: esophagus, rupture, treatment, operation