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目的分析食管癌术后吻合口瘘的发生原因,探讨积极地临床预防措施。方法选取行食管癌根治术治疗的患者1 000例,术后发生食管癌术后吻合口瘘10例,分析导致食管癌术后吻合口瘘的原因,并在此基础上探讨有效的临床预防措施。结果食管癌术后吻合口瘘发生率为1.0%(10/1000),包括术前因素3例、术中因素3例和术后因素4例。其中颈部吻合332例,术后发生吻合口瘘3例,发生率为0.9%;胸腔吻合668例,术后发生吻合口瘘7例,发生率为1.0%。结论食管癌术后吻合口瘘发生是综合因素共同作用的结果,主要与术前、术中和术后操作和管理有密切的关系,加强术前、术中和术后的治疗管理能够有效降低患者食管癌术后吻合口瘘的发生率。
Objective To analyze the causes of anastomotic fistula after esophageal cancer operation and to explore the positive clinical preventive measures. Methods A total of 1 000 patients underwent radical resection of esophageal cancer were selected. 10 cases of postoperative esophagogastric anastomotic fistula occurred after esophageal cancer surgery. The causes of anastomotic leakage after esophageal cancer were analyzed. Based on this, effective clinical preventive measures . Results The incidence of anastomotic leakage after esophagectomy was 1.0% (10/1000), including 3 cases of preoperative factors, 3 cases of intraoperative factors and 4 cases of postoperative factors. There were 332 cases of anastomosis in the neck, 3 cases of anastomotic fistula occurred after operation, the incidence rate was 0.9%, 668 cases of anastomosis of thoracic cavity, 7 cases of anastomotic fistula occurred after operation, the incidence was 1.0%. Conclusions The occurrence of anastomotic fistula after esophagectomy is the result of the combination of factors, which is mainly related to the operation and management before, during and after operation. It is concluded that strengthening the management of preoperative, intraoperative and postoperative management can be effectively reduced The incidence of postoperative anastomotic fistula in patients with esophageal cancer.