食管穿孔83例分析

８３例不同原因引起的食管穿孔，保守治疗５７例；手术２６例，行单纯食管修补术２０例、开胸行纵隔和／或胸腔引流２例、切除贲门肿物行胃食管吻合１例、颈部食管外置２例（其中１例并行二期结肠代食管手术）、１例开胸取异物形成食管瘘后，行二期修补瘘术。全组死亡８例，其中死于纵隔胸腔感染和主动脉破裂出血各４例。总治愈率８５％。并指出异物假牙造成食管穿孔的重要性，对严重的腐蚀性食管灼伤应早期行食管镜检，并针对食管穿孔部位、种类、间隔期、纵隔与胸腔的感染程度及病人具体情况采取相应的治疗措施。

Analyses of 80 Cases of Perforation of Esophagus

Eighty three cases of esophageal perforation were analysed. Conservative treatment was employed in 57 cases,twenty six patients underwent operations including esophageal repair in 20,drainage of mediastinum or pleura cavity in 2,esophagogastrostomy with resection of carcinoma of the cardia in 1,exteriorization of the cervical esophagus in 2 and colonic interposition in 1,esophagotomy with removal of the foreign bodies and later rapair of the fistula in 1.Four died of aortic rupture,4 of serious and uncontrollable mediastinal and pleural infection. The over-all cure rate of this group was 85%.The author emphasized the seriousness of esophageal perforation caused by foreign bodies especially false teeth.Esophagoscopy should be performed in corrosive burns of the esophagus.Choice of appropriate treatment for esophageal perforation should be based on the site, cause, duration. severity of mediastinitis and patient's general condition.