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本文报道胸內食管胃吻合口痿13例治疗的临床体会,本组病例小痿5例、中痿3例,大瘘5例,均行保守治疗,2例死亡(15.4％),11例治愈(84.6％)。治愈的经验为:1.早期诊断和及时处理吻合口痿是治愈的关键.2.一旦确诊应立即放置胸腔引流管,引流管必须有效。3.中、小瘘采取保守治疗,大痿除在充分准备下再次手术外,亦可行保守治疗。4.瘘发生后必然伴发脓胸,故使用有效的抗菌素。供给大量营养和保持水电解质平衡极为重要。
This article reported the clinical experience of 13 cases of intrathoracic esophagogastric anastomotic fistulas. There were 5 cases of small blepharospasm, 3 cases of medial malleolar fistula, and 5 cases of bullae in this group. All patients were treated conservatively, 2 cases died (15.4%), and 11 cases were cured. (84.6%). The healing experience is: 1. Early diagnosis and timely treatment of anastomotic fistula is the key to cure. 2. Once the diagnosis is confirmed, the chest drainage tube should be immediately placed and the drainage tube must be effective. 3. Conservative treatment is adopted for the middle and small-armed patients. The deafness can be treated conservatively unless it is re-operated under adequate preparation. 4. After the occurrence of hemorrhoids, it will be associated with empyema, so the use of effective antibiotics. It is extremely important to provide plenty of nutrients and maintain water and electrolyte balance.