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目的:探讨食管重建术中留置食管引流管并持续负压引流对术后吻合口漏和吻合口狭窄的影响作用和临床效果。方法:收集2013年1月至2019年12月在上海交通大学医学院附属新华医院接受手术治疗并痊愈出院的先天性食管闭锁（congenital esophageal atresia，CEA）患儿的相关资料。将放置食管引流管并术后持续负压引流的患儿作为A组，将未放置食管引流管的患儿作为B组。本研究共纳入130例患儿，其中男84例，女46例；A组81例，男51例，女30例，出生孕周为（37. 6± 2. 0）周，出生体重为（2 737±482) g, 42. 0%（34/81）存在伴发畸形；B组49例，男33例，女16例，出生孕周为（37.8±2. 2）周，出生体重为（2 826±628) g, 32. 7%（16/49）存在伴发畸形。收集并比较两组患儿的人口统计学信息、手术方式及技巧、呼吸机使用、并发症及诊治情况。结果:71. 5%（93/130）的患儿接受胸腔镜手术，28. 5%（37/130）的患儿接受开胸手术。所有患儿在术后达到经口喂养后出院，术后随访时间范围为10~60个月。A组术后吻合口漏发生率低于B组，为18. 5%（15/81）比34. 7%（17/49），差异具有统计学意义（n P=0. 038）。A组中Ⅰ型及Ⅱ型CEA患儿多于B组，为45. 7%（37/81）比26. 5%（13/49），差异具有统计学意义（n P=0. 030）。A组术中食管近远端缺失长度较B组大，为（3. 3± 1. 7) cm比（2. 7±1. 2) cm，差异具有统计学意义（n P=0. 039）。术后，A组的呼吸机使用时间较B组稍长，为（8. 8±9. 2) d比（6. 1±7. 9) d，差异无统计学意义（n P=0. 090）；A组住院时间少于B组，为（48. 7± 38. 0) d比（68. 6±52. 9）d，差异具有统计学意义（n P=0. 015）；A组吻合口狭窄的发生率高于B组，65. 4%（53/81）比49. 0%（24/49），差异无统计学意义（n P=0. 064）；在吻合口狭窄需行食管扩张次数方面两组的差异无统计学意义（n P=0. 313），为（10. 3±7.8）次比（8. 3±7. 1）次。n 结论:食管重建术中留置食管引流管并持续负压引流可以有效降低患儿术后吻合口漏的发生率，有助于改善术后恢复进程，缩短住院时间。“,”Objective:To explore the clinical efficacy of indwelling esophageal negative pressure drainage tube and continuous negative pressure drainage on postoperative anastomotic leakage and anastomotic stricture during esophageal reconstruction.Methods:From January 2013 to December 2019, the relevant clinical data were collected from 130 children with congenital esophageal atresia (CEA). There were 84 boys and 46 girls. Children with esophageal drainage tube placement and postoperative continuous negative pressure drainage were selected as group A (n=81) while those without esophageal tubing as group B (n=49) . In group A, there were 51 boys and 30 girls with a birth age of (37. 6±2. 0) weeks and a birth weight of (2 737±482) grams. And 42. 0% (34/81) were malformed. In group B, there were 33 boys and 16 girls with a birth age of (37.8±2.2) weeks and a birth weight of (2 826±628) grams. And 32. 7% (16/49) were malformed. Demographic profiles, surgical approaches & techniques, ventilator use, complications and diagnosis & treatment were compared between two groups.Results:Thoracoscopy (71. 5%, 93/130) and thoracotomy (28. 5%, 37/130) were performed. Discharges occurred after achieving feeding and postoperative follow-up period ranged from 10 to 60 months. The postoperative incidence of anastomotic leakage was lower in group A than that in group B [18. 5% (15/81) vs 34. 7% (17/49) ]and the difference had statistical significance (n P=0. 038) . There were more children with type Ⅰ & Ⅱ CEA in group A than in group B [45. 7% (37/81) vs 26. 5% (13/49) ]and the difference was statistically significant ( n P=0. 030) . The intraoperative proximal and distal esophageal distance was greater in group A than that in group B[ (3. 3±1. 7) vs (2. 7±1. 2) cm]and the difference had statistical significance (n P=0. 039) . After operation, ventilator time was slightly longer in group A than that in group B [ (8. 8±9. 2) vs (6. 1± 7. 9) days]and the difference had no statistical significance (n P=0. 090) ; hospital stay was shorter in group A than that in group B [ (48. 7±38. 0) vs (68. 6±52. 9) days]and the difference had statistical significance (n P=0. 015) ; the incidence rate of anastomotic stricture was higher than that in group B [65. 4% (53/81) vs 49. 0% (24/49) ]and the difference had no statistical significance (n P=0. 064) ; the difference in the number of esophageal dilatation required for anastomotic stricture had no statistical significance [ (10. 3±7. 8) vs (8. 3±7. 1) sessions, n P=0. 313].n Conclusions:Indwelling esophageal drainage tube and continuous negative pressure drainage during esophageal reconstruction can effectively reduce the incidence of postoperative anastomotic leakage, improve postoperative recovery and shorten length of hospitalization stay in children.