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目的:简析梨状窝瘘误诊原因并探讨对策。方法:选择食管钡餐造影,注入亚甲蓝1~2 m l术中引导下以整块切除包括瘘管在内的病变组织,结扎切除位于梨状窝的瘘口。结果:按意向处理分析,3例病例经3个月随访,创面未出现破溃,食道钡透示瘘管消失。中途无脱落。结论:对其发生及病理学认识不足是主要的误诊原因,根治方法是瘘管完全切除。选择食管钡餐造影能明确诊断。
Objective: To analyze the causes of misdiagnosis of pear-shaped fistula and to discuss the countermeasures. Methods: Select the esophageal barium meal angiography, injection of methylene blue 1 ~ 2 m l under the guidance of surgery to remove the fistula, including the entire lesion, ligation resection fissure located in the pear-shaped fossa. Results: According to the analysis of intention to treat, three cases were followed up for 3 months, the wound surface did not rupture, and the fistula disappeared in the esophagus. No shedding midway. Conclusion: The lack of understanding of its occurrence and pathology is the main cause of misdiagnosis. The radical method is complete fistula resection. Select barium meal esophageal imaging can confirm the diagnosis.