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食管胃吻合口瘘

食管胃吻合口瘘的相关文献在1993年到2021年内共计110篇,主要集中在肿瘤学、外科学、临床医学 等领域,其中期刊论文100篇、会议论文4篇、专利文献21531篇;相关期刊87种,包括大家健康(中旬版)、家庭保健、医疗装备等; 相关会议4种,包括第十届全国消化道恶性病变介入诊疗研讨会暨2010消化介入/内镜新技术国际论坛暨2010成都消化年会、2010全国肠外肠内营养学术会议、第八届中国介入放射学大会等;食管胃吻合口瘘的相关文献由275位作者贡献,包括吴刚、韩新巍、严俊等。

食管胃吻合口瘘—发文量

期刊论文>

论文:100 占比:0.46%

会议论文>

论文:4 占比:0.02%

专利文献>

论文:21531 占比:99.52%

总计:21635篇

食管胃吻合口瘘—发文趋势图

食管胃吻合口瘘

-研究学者

  • 吴刚
  • 韩新巍
  • 严俊
  • 刘震威
  • 周学良
  • 周静
  • 张全会
  • 张勤
  • 曾雁伟
  • 朱华
  • 期刊论文
  • 会议论文
  • 专利文献

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    • 张富军
    • 摘要: 目的:临床当中针对食管胃吻合口瘘患者实施诊断当中,探究头低足高位X线造影的临床诊断效果.方法:选取医院当中23例疑似食管胃吻合口瘘患者为对象,采用常规和头低足高位X线造影方法展开检查.为所有患者提供非离子型对比剂,为未显示出吻合口瘘患者提供稀钡检查.及时对比两组检查方法检出吻合口瘘的几率.结果:为患者提供非离子型对比剂之后,检出吻合口瘘52.20%(12/23);针对未检出吻合口瘘的患者11例,提供头低足高位X线造影方法检查,再次检出6例吻合口瘘;最后针对未检出吻合口瘘的患者实施稀钡检查,检出2例吻合口瘘患者.结论:针对食管胃吻合口瘘这一疾病实施临床诊断,引入头低足高位X线造影方法的这一方法,可以有效提高疾病的检查效率,具有较高的诊断准确率,为患有此疾病的患者治疗带来更加精确的影像学的参考依据,临床当中值得推广.
    • 严英光
    • 摘要: 目的 探讨中下段食管鳞状细胞癌Sweet术后颈部食管胃吻合口瘘的高危因素分析.方法 通过对2015年2月至2017年3月就诊收治的280例择期行Sweet术治疗的食管胸中下段鳞癌患者临床资料做回顾性分析,记录所有患者年龄、性别、合并基础病情况、肿瘤部位、TNM分期、制作管状胃、吻合方式、吻合口包埋、术后肺部感染、术后纤维支气管镜吸痰等.采用logistic回归分析颈部食管胃吻合口瘘发生的影响因素.结果 本组280例患者均成功行Sweet手术,共有50例(17.86%)患者出现颈部食管胃吻合口瘘.年龄≥60岁、性别、合并糖尿病、制作管状胃、术后肺部感染、术后应用纤维支气管镜吸痰是中下段食管鳞状细胞癌Sweet术后颈部食管胃吻合口瘘发生的影响因素(P<0.05).制作管状胃(OR=1.921,95%CI:1.065~3.466)、术后肺部感染(OR=1.881,95%CI:1.047~3.380)、术后纤维支气管镜吸痰(OR=1.898,95%CI:1.151~3.130)是食管癌Sweet术后颈部食管胃吻合口瘘发生的独立危险因素(P<0.05).结论 制作管状胃、术后肺部感染、术后纤维支气管镜吸痰是中下段食管鳞状细胞癌Sweet术后颈部食管胃吻合口瘘发生的独立危险因素,应当注重并提前干预,可减少颈部食管胃吻合口瘘的发生.
    • 邱龙; 李向楠; 赵松; 赵佳; 朱登彦; 杨洋; 原锋锋; 张开上; 郑少忠
    • 摘要: Objective To investigate the risk factors of cervical esophagogastric anastomotic fistula after esophagectomy of esophageal cancer.Methods The retrospective case-control study was conducted.The clinicopathological data of 956 patients who underwent esophagectomy and cervical esophagogastrostomy from January 2012 to December 2016 in the First Affiliated Hospital of Zhengzhou University were collected.Patients underwent Sweet or Mckeown surgery.Observation indicators:(1) intra-and post-operative situations;(2) the risk factors analysis of cervical esophagogastric anastomotic fistula after esophagectomy;(3) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the esophagogastric anastomotic stenosis of patients up to February 2017.Measurement data with normal distribution were represented as the (x)±-s.Univariate analysis and comparison of count data were done using the chi-square test or Fisher exact probability method.Multivariate analysis was done using the Logistic regression model.Results (1) Intra-and post-operative situations:all the 956 patients underwent successful operations,including 107 with Sweet operation and 849 with Mckeown operation.Of 956 patients,336 received thoracotomy and 620 received thoracoscopic surgery.Tumors located in upper,middle and lower esophagus were respectively detected in 143,627 and 186 patients.Operation time,volume of intraoperative blood loss and number of lymph node dissected in 956 patients were (274 ± 67) minutes,(210 ± 167) mL and 18 ± 11,respectively.Of 956 patients,117 had cervical esophagogastric anastomotic fistula,with an incidence of anastomotic fistula of 12.24% (117/956).Of 117 patients with cervical esophagogastric anastomotic fistula,2 had early stage fistula,110 had middle stage fistula and 5 had later stage fistula;12 were cured by two-tube method (stomach tube and nutrition tube),24 were cured by three-tube method (stomach tube,nutrition tube and chest tube or mediastinal tube),43 were cured by open neck incision dressing,15 were cured by fistula cavity drainage and 17 were cured by esophageal stent implantation.Sixteen patients died in hospital postoperatively,including 6 with cervical esophagogastric anastomotic fistula and 10 without cervical esophagogastric anastomotic fistula.Duration of hospital stay of 956 patients was (16± 11)days,and durations of hospital stay of patients with and without cervical esophagogastric anastomotic fistula were (39± 19) days and (13±6) days.Postoperative pathological examinations:873,9 and 74 patients were respectively diagnosed with squamous cell carcinoma,adenocarcinoma and other types of cancer.TNM staging:stage 0,Ⅰ,Ⅱ,Ⅲ,Ⅳ and unidentified stage were respectively detected in 135,110,325,376,1 and 10 patients.(2) The risk factors analysis of cervical esophagogastric anastomotic fistula after esophagectomy:univariate analysis showed that gender,age,history of diabetes,surgical method,tubular stomach production,operation time,postoperative pulmonary infection and postoperative aspirating sputum through fiberbronchoscope were risk factors affecting cervical esophagogastric anastomotic fistula after esophagectomy,with statistically significant differences (x2 =4.179,6.174,4.427,4.377,6.266,7.057,55.036,51.806,P< 0.05).Multivariate analysis showed that tubular stomach production,postoperative pulmonary infection and aspirating sputum through fiberbronchoscope were independent risk factors affecting cervical esophagogastric anastomotic fistula after esophagectomy,with statistically significant differences (OR =1.922,2.907,2.323,95% confidence interval:l.203-3.070,1.682-5.023,1.235-4.370,P<0.05).(3) Follow-up situations:908 of 956 patients were followed up for 2-62 months,with a median follow-up time of 28 months.During the follow up,21 of 111 patients with cervical esophagogastric anastomotic fistula were complicated with cervical esophagogastric anastomotic stenosis,59 of 797 patients without cervical esophagogastric anastomotic fistula were complicated with cervical esophagogastric anastomotic stenosis,showing a statistically significant difference in cervical esophagogastric anastomotic stenosis (x2-16.803,P<0.05).Conclusion Tubular stomach production,postoperative pulmonary infection,postoperative aspirating sputum through fiberbronchoscope are independent risk factors affecting cervical esophagogastric anastomotic fistula after esophagectomy.%目的 探讨影响食管癌术后颈部食管胃吻合口瘘的危险因素.方法 采用回顾性病例对照研究方法.收集2012年1月至2016年12月郑州大学第一附属医院收治的956例行颈部食管胃吻合的食管癌根治术患者的临床病理资料.全组患者行Sweet手术或Mckeown手术.观察指标:(1)术中及术后情况.(2)影响术后颈部食管胃吻合口瘘的危险因素分析.(3)随访情况.采用门诊和电话方式进行随访,了解患者颈部食管胃吻合口狭窄情况.随访时间截至2017年2月.正态分布的计量资料采用(x)±s表示.单因素分析及计数资料比较采用x2检验或Fisher确切概率法;多因素分析采用Logistic回归模型.结果 (1)术中及术后情况:956例患者均成功完成手术,其中Sweet手术107例,Mckeown手术849例;开胸手术336例,胸腔镜手术620例.肿瘤部位:食管上段143例,食管中段627例,食管下段186例.956例患者手术时间为(274±67) min,术中出血量为(210± 167) mL,清扫淋巴结数目为(18±11)枚.956例患者中,术后发生颈部食管胃吻合口瘘117例,吻合口瘘的发生率为12.24%(117/956).117例颈部食管胃吻合口瘘患者中,早期瘘2例,中期瘘1 10例,晚期瘘5例;两管法(胃管、营养管)治愈12例,三管法(胃管、营养管、胸管或纵隔管)治愈24例,颈部切口拆开换药治愈43例,瘘腔置管冲洗治愈15例,食管支架置入治愈17例.术后院内死亡16例,其中颈部食管胃吻合口瘘患者6例,无颈部食管胃吻合口瘘患者10例.956例患者术后住院时间为(16±11)d,其中颈部食管胃吻合口瘘患者术后住院时间为(39±19)d,无颈部食管胃吻合口瘘患者术后住院时间为(13±6)d.术后病理学检查:鳞癌873例,腺癌9例,其他类型癌74例.TNM分期:0期135例,Ⅰ期110例,Ⅱ期325例,Ⅲ期376例,Ⅳ期1例,未确定分期10例.(2)影响术后颈部食管胃吻合口瘘的危险因素分析:单因素分析结果显示:性别、年龄、糖尿病史、手术方式、制作管状胃、手术时间、术后肺部感染、术后纤维支气管镜吸痰是影响食管癌术后颈部食管胃吻合口瘘的危险因素,差异均有统计学意义(x2=4.179,6.174,4.427,4.377,6.266,7.057,55.036,51.806,P<0.05).多因素分析结果显示:制作管状胃、术后肺部感染、术后纤维支气管镜吸痰是影响食管癌术后颈部食管胃吻合口瘘的独立危险因素,差异均有统计学意义(OR=1.922,2.907,2.323,95%可信区间:1.203 ~3.070,1.682~5.023,1.235 ~4.370,P<0.05).(3)随访情况:956例患者中,908例获得术后随访,随访时间为2~ 62个月,中位随访时间为28个月.随访期间,1 11例术后颈部食管胃吻合口瘘患者中,21例发生颈部食管胃吻合口狭窄;797例无颈部食管胃吻合口瘘患者中,59例发生颈部食管胃吻合口狭窄,两者吻合口狭窄发生情况比较,差异有统计学意义(x2=16.803,P<0.05).结论制作管状胃、术后肺部感染、术后纤维支气管镜吸痰是食管癌术后颈部食管胃吻合口瘘的独立危险因素.
    • 苏广利; 王洪琰; 李资建
    • 摘要: 目的 观察评价胸腔引流管为主的"三管"法和透视引导下经鼻置入瘘腔负压引流管为主的新"三管"法治疗食管癌术后食管胃吻合口瘘的近期治疗效果.方法 90例食管癌术后食管胃吻合口瘘患者随机分为对照组与观察组,每组各45例.对照组采用胸腔引流管为主的"三管"法治疗,观察组采用透视引导下经鼻置入瘘腔负压引流管为主的新"三管"法治疗.比较两组的平均住院时间、疼痛VAS评分、体力恢复状况、镇静评分等指标.结果 观察组患者平均住院时间为(27.41±10.23)d,明显低于对照组的(53.26±13.27)d,差异有统计学意义(t=9.005,P<0.0001);观察组的疼痛VAS评分、体力恢复状况评分分别为(2.70±1.47)分、(2.11±0.82)分,均明显低于对照组的(6.58±4.32)分、(3.87±1.98)分,差异有统计学意义(t=10.003,8.273;P<0.0001);两组镇静Ramsay评分比较差异无统计学意义(t=0.215,P=0.832);观察组病死率(4.44%)明显低于对照组(26.67%),治愈率(84.44%)明显高于对照组(51.11%),观察组的预后明显优于对照组,差异具有统计学意义(Z=3.498,P=0.000).结论 临床应用经鼻置入瘘腔负压引流管为主的新"三管"法治疗食管癌术后食管胃吻合口瘘,其操作较简单,可提高患者治愈率,缩短住院时间,缓解患者疼痛,促进体力恢复,值得进一步推广.%Objective To observe and evaluate the short-term efficacy of chest tube-based"three tubes"therapy and the new"three tubes"using fluoroscopically-guided transnasal tube insertion in the treatment of esophagogastric anasto-motic fistula after esophagectomy for esophageal carcinoma. Method 90 patients with esophagogastric anastomotic fis-tula after esophagectomy for esophageal carcinoma were included in the study and randomized as control group and study group with 45 cases in each. The control group received chest tube-based"three tubes"therapy;And the study group was administered with fluoroscopically-guided transnasal tube insertion-based new"three tubes"therapy. The average hospital stay, VAS scores of pain, physical recovery, sedation scores and other indicators of the two groups were compared. Result The average time of hospital stay of the study group was (27.41±10.23) d, which was significantly shorter than that of the control group at (53.26 ± 13.27) d (t=9.005, P<0.0001);VAS scores of pain, and ZPS score was (2.70 ± 1.47) and (2.11 ± 0.82) in study group, and were significantly lower than those of the control group at (6.58±4.32) and (3.87±1.98), respec-tively (t=10.003, P<0.0001;t=8.273, P<0.0001);Ramsay sedation scores were similar between the two groups (t=0.215, P=0.832);While higher mortality rate (4.44%) was observed in study group compared with control group (26.67%), be-sides, the study group had higher cure rate (84.44%) than the control group (51.11%), with better prognosis (Z=3.498, P=0.000). Conclusion The clinical application of the new"three tubes"therapy with transnasal tube insertion is applicable and feasible in the treatment of esophagogastric anastomotic fistula after esophagectomy for esophageal carcinoma, with improved cure rate, less hospital stay, minor pain and accelerated recovery.
    • 谭家龙
    • 摘要: 目的:探析微创细管法治疗食管胃吻合口瘘的临床效果.方法:选取该院2015年1 ~10月医治的80例食管胃吻合口瘘患者资料,按不同的医治方案分成2组,行传统置管法医治的40例患者设对照组,行微创细管法医治的40例患者设研究组,比对两组临床指标与医治疗效.结果:研究组VAS与ECOG评分较对照组低,治愈时间与稳定时间较对照组短,医治有效率较对照组高(P<0.05).结论:食管胃吻合口瘘患者行微创细管法医治可缩短治愈及稳定的时间,改善体力状态,减轻疼痛.
    • 高峰
    • 摘要: 目的:探讨头低足高位X线造影在食管胃吻合口瘘患者中的诊断方法及价值.方法:选择2013年3月-2014年3月在我院接受治疗的疑似食管胃吻合口瘘患者23例,采用常规X线造影、头低足高位X线造影进行检查.对所有患者均给予非离子型对比剂,未显示吻合口瘘患者再给予稀钡.记录两种检查方式在吻合口瘘中的检出率.结果:采用非离子型对比剂后,吻合口瘘检出率为52.2%(12/23),其中对比剂未向远处弥散有8例,弥散至胸腔膜有3例,弥散纵膈内有1例;对于未检出吻合口瘘的患者11例采用头低足高位X线造影方式进行检查,再次检出吻合口瘘有6例,给予稀钡后检出2例.结论:采用头低足高位X线造影方式,能够有效提高疑似食管胃吻合口瘘患者的检出率,诊断准确率高,为患者的后续治疗提供了有效的影像学参考依据,因此值得在临床上进一步推广应用.
    • 隋广平; 刘颖; 尹立刚; 赵春
    • 摘要: 目的 研究头低足高位X线造影对食管胃吻合口瘘的诊断价值.方法 选取2014年3月至2016年4月医院收治的41例疑诊为食管胃吻合口瘘患者,所有患者先行常规X线非离子型造影检查,未见吻合口瘘者行头低足高位X线造影检查,口服非离子型造影剂后,如未暴露食管胃吻合口瘘,则可再口服稀钡,记录常规X线造影和头低足高位检查的检查结果.结果 常规X线非离子型对比剂造影检查结果提示左侧29例,右侧12例,检出吻合口瘘26例,17例对比剂仅局限于瘘口,5例对比剂弥散于纵隔,4例对比剂弥散于胸膜腔(融合与胸腔积液).余15例未见吻合口瘘者行头低足高位X线造影检查,结果显示9例发现吻合口瘘,剩余6例口服稀钡,结果提示2例可见吻合口瘘,4例未见胃吻合口瘘患者,对症治疗后3~5d后,临床症状消失.结论 头低足高位X线造影检查能够提高食管胃吻合口瘘的检出率,降低漏诊发生率,为临床诊断提供参考依据.
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