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find Keyword "自发性食管破裂" 6 results
  • Diagnosis and Treatment of 34 Patients with Spontaneous Esophageal Rupture

    Objective?To investigate clinical characteristics, diagnosis, and treatment for patients with spontaneous esophageal rupture, and improve clinical diagnostic and treatment level.?Methods?We retrospectively analyzed the clinical data of 34 patients with spontaneous esophageal rupture who were treated in Subei People’s Hospital from January 1996 to June 2010. There were 28 male patients and 6 female patients with their age ranging from 32 to 80 years old (mean 57.6 years old). Main clinical manifestations included severe chest and abdominal pain after vomiting, fever, dyspnea and shock. The duration between disease onset and establishing diagnosis ranged from 4 hours to 7 days. Thirteen patients received conservative treatment including chest drainage, retrograde gastrointestinal decompression and enteral nutrition through jejunostomy. Twenty one patients received surgical treatment including layered anastomosis of the ruptured esophagus, retrograde gastrointestinal decompression and enteral nutrition through jejunostomy.?Results?All the patients were cured without in-hospital death. The mean hospital stay of the 13 patients who received conservative treatment was 46 days, while that of the 21 patients who received surgical treatment was 17 days. All the ruptured esophagus were one-stage healed. All the 34 patients were followed up from l to 8 years, including 11 patients in the conservative treatment group and 19 patients in the surgical treatment group, but 4 patients was lost during follow-up. All the patients had a normal diet without symptoms of esophageal stricture, reflux esophagitis or chronic thoracic empyema.?Conclusion Spontaneous esophageal rupture is a thoracic emergency with a high misdiagnosis rate and mortality.Early diagnosis, early surgical repair of ruptured esophagus and satisfactory chest drainage play a vital role in the treatment for patients with spontaneous rupture of esophagus.

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
  • Clinical Diagnosis and Treatment of Spontaneous Esophageal Rupture:A Report of 14 Patients

    Objective?To summarize our experience of surgical treatment of Boerhaave’s Syndrome. Methods We retrospectively analyzed clinical records of 14 patients with Boerhaave’s syndrome in West China Hospital between January 1998 and December 2011. There were 11 male patients and 3 female patients with a mean age of 55.2±14.4 years and mean time interval between onset and admission of 49.6±21.2 h. Primary repair was performed in 11 patients.Esophagectomy and reconstruction of digestive track was performed in 1 patient and intra-luminal stent implantation was applied in 1 patient. Intercostal catheter insertion was performed in 1 patient.?Results?Thirteen patients underwent surgical therapy, and their survival rate was 84.6% (11/13). Among the eleven patients who underwent primary repair, 8 patients (72.7%)were cured and 3 patients experienced postoperative leakage resulting 2 deaths. The other one patient was cured with in-hospital time of 22.3±7.0 d. Two patients underwent digestive track reconstruction and intra-luminal stent implantation respectively and all survived with in-hospital time 39.0±5.7 d. Another patient underwent bedside chest drainage and died 10 d after admission.?Conclusion?Aggressive surgical management is an effective way to treat Boerhaave’s syndrome, and primary repair can lead to ideal prognosis in delayed patients whose time interval between onset and admission is beyond 24 h. Digestive track reconstruction and intra-luminal stent implantation are alternative methods on condition that primary repair can not be accomplished.

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
  • 自发性食管破裂的诊断与治疗

    摘要: 目的 总结自发性食管破裂的诊治经验, 提高对该病的诊治水平。 方法 回顾性分析我院2000年10月至2008年12月收治的21例自发性食管破裂患者的临床资料,男18例, 女3例;年龄24~59岁,平均年龄40.5岁。行开胸手术治疗19例,其中行食管裂口修补术13例,食管部分切除、食管胃吻合术4例,单纯胸腔清洗引流2例;11例加做空肠造瘘术,8例置放空肠营养管。未行手术而仅行抗感染对症支持治疗2例。 结果 19例开胸手术患者中,痊愈16例(84.21%),死亡3例,分别因严重纵隔感染中毒性休克、吻合口瘘、纵隔感染各死亡1例;经保守治疗的2例患者均死于严重感染、多器官功能衰竭。随访16例,随访时间3个月~8年,随访期间无明显食管反流和食管狭窄等并发症发生。 结论 自发性食管破裂通过早期、积极、有效的外科治疗,预后良好;术后保证引流通畅、加强营养、预防和控制感染是治疗该病的关键。

    Release date:2016-08-30 06:02 Export PDF Favorites Scan
  • 自发性食管破裂的早期诊断与治疗

    目的 总结自发性食管破裂的早期诊断、治疗方法及临床疗效。 方法 2004 年1 月- 2006 年6 月,收治15 例自发性食管破裂男性患者。年龄38 ~ 56 岁,平均46 岁。发病至确诊时间为6 ~ 72 h,其中lt; 24 h 12 例。暴食后上腹受压憋气所致3 例,暴食后跌伤1 例,大量饮酒后呕吐所致11 例。破口位于食管中下段或下段,长4 ~ 12 cm。1 例发病后于外院行内支架治疗并发食管、气管瘘1 个月,入院确诊后放弃治疗。余14 例均手术治疗,其中行食管修补术8 例,食管切除、食管胃吻合术6 例。 结果 14 例术后顺利恢复,住院11 ~ 18 d。无手术死亡、吻合口瘘和其他并发症发生。2 例术后2 个月出现吻合口轻度狭窄(0.6 ~ 0.8 cm),仅进流食,经胃镜直视下行球囊扩张后缓解。14 例获随访,随访时间6 个月~ 2 年。无进食困难及哽咽不适。行上消化道碘化油造影示吻合口通畅,食管无扩张,消化功能良好。 结论 自发性食管破裂经早期诊断和手术治疗均易治愈,并发症少,预后满意。

    Release date:2016-09-01 09:17 Export PDF Favorites Scan
  • REPAIR OF SPONTANEOUSRUPTURE OF ESOPHAGUSBY PEDICL ED GREATER OMENTUM(10 Cases Re- port)

    OBJECTIVE To evaluate the effect of various covering tissues for improving the cure rate of spontaneous rupture of esophagus. METHODS From 1970 to 1994, 13 cases with spontaneous rupture of esophagus were performed primary repair, among them, 10 cases were covered by pedicled greater omentum after impair, and the other 3 cases were covered by pedicled pleural flap. RESULTS: Satisfactory result and complete recovery were obtained in all 10 cases by using pedicled greater omentum. Two cases among 3 cases using pedicled pleural flap suffered re-rupture of esophagus at 5 days and 8 days after operation, and died because of whole body exhaustion. CONCLUSION Pedicled greater omentum is a good covering tissue for repair of spontaneous rupture of esophagus.

    Release date:2016-09-01 10:26 Export PDF Favorites Scan
  • Clinical Analysis of 8 Patients with Spontaneous Esophageal Rupture

    摘要:目的: 探讨自发性食管破裂的诊断和治疗经验。 方法 :对我院1996年2月至2009年8月收治的8例自发性食管破裂患者的诊断和治疗作回顾性分析。 结果 :全组患者7例行手术治疗,1例行保守治疗。6例患者行修补手术,其中4例行分层缝合,2例行全层缝合。1例行食管切除胃食管吻合术。本组痊愈7例,死亡1例。 结论 :早期诊断和早期治疗是自发性食管破裂的治疗原则。确诊患者,若病情允许,应首选手术治疗。Abstract: Objective: To explore the clinical diagnosis and treatment of spontaneous esophageal rupture. Methods :The clinical features, diagnosis and surgical treatment of 8 patients with spontaneous esophageal rupture were retrospectively reviewed. Results :There were 7 cases treated by surgical therapy and 1 case for conservative treatment. 6 cases were treated by surgical repair including 4 cases of layered suture and 2 cases of singlelayer suture. 1 case was treated by esophagus resection and gastroesophagostomy. In the whole group, 7 cases were cured and 1 case died. Conclusion :The therapeutic principle of spontaneous esophageal rupture are early diagnosis and early treatment. For diagnosed patient, surgical procedure is the first choice if condition permitted.

    Release date:2016-09-08 10:12 Export PDF Favorites Scan
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