本文選題：氣管食管瘺　切入點(diǎn)：stapler　出處：《蘭州大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:研究Stapler技術(shù)在治療頸段氣管食管瘺中的臨床療效。方法:回顧性分析2014年10月-2016年10月在蘭州大學(xué)第二醫(yī)院胸外科收治的8例氣管食管瘺患者的臨床資料,男女之比為5:3,其中4例患者氣管食管瘺由氣管插管導(dǎo)致,2例由食管異物導(dǎo)致,1例由氣管支架導(dǎo)致,1例由食管憩室導(dǎo)致;他們?nèi)拷邮躍tapler技術(shù)閉合瘺口,術(shù)后通過KPS評(píng)分、影像學(xué)改善情況、患者滿意度調(diào)查和患者進(jìn)食嗆咳癥狀改善情況來評(píng)價(jià)手術(shù)效果。結(jié)果:手術(shù)過程順利,手術(shù)時(shí)間為(117.5±6.6)min,術(shù)中出血量為(60±7.0)mL。術(shù)后患者無切口出血感染、無聲音嘶啞呼吸困難、無飲水嗆咳、無瘺口復(fù)發(fā)、無氣管食管狹窄等并發(fā)癥,無圍手術(shù)期死亡病例,1周后拍胸部X線片示肺部感染癥狀消失,僅有1例患者術(shù)后1年出現(xiàn)食管狹窄。術(shù)后2周KPS(Karnofsky-功能狀態(tài)評(píng)分)評(píng)分為(90±7.0),較術(shù)前明顯改善(p0.01),術(shù)后肺部感染面積較術(shù)前減少(p0.05),氣管食管瘺道消失,患者總體滿意率為90%,進(jìn)食嗆咳癥狀改善情況評(píng)價(jià)為優(yōu)。結(jié)論:Stapler技術(shù)是治療頸段氣管食管瘺的有效術(shù)式,具有安全、簡(jiǎn)便,手術(shù)時(shí)間短,術(shù)后并發(fā)癥少,療效可靠等優(yōu)點(diǎn)。
[Abstract]:Objective: to study the clinical effect of Stapler in the treatment of cervical tracheoesophageal fistula. Methods: the clinical data of 8 patients with tracheoesophageal fistula treated in Department of Thoracic surgery, second Hospital of Lanzhou University from October 2014 to October 2016 were retrospectively analyzed. The ratio of male to female was 5: 3, of which 4 patients had tracheoesophageal fistula caused by tracheal intubation, 2 patients by esophageal foreign body, 1 by tracheal stents, 1 by esophageal diverticulum, they all received Stapler technique to close the fistula, which was scored by KPS after operation. Results: the operation process was smooth, the operation time was 117.5 鹵6.6 min, the intraoperative bleeding volume was 60 鹵7.0 mL. there was no wound bleeding infection after operation. There were no complications such as hoarseness dyspnea, no coughing in drinking water, no recurrence of fistula, no tracheoesophageal stenosis and so on. The chest X-ray film taken after 1 week of perioperative death showed that the symptoms of pulmonary infection disappeared. Only one patient developed esophageal stricture one year after operation. The score of KPSN Karnofsky- functional state at 2 weeks after operation was 90 鹵7.0, which was significantly better than that before operation (P 0.01). The area of postoperative pulmonary infection was reduced by p0.05 and the tracheoesophageal fistula disappeared. The overall satisfaction rate of the patients was 90, and the improvement of choking cough symptom was superior. Conclusion: Stapler technique is an effective method for the treatment of cervical tracheoesophageal fistula. It has the advantages of safety, simplicity, short operation time, less postoperative complications, reliable curative effect, and so on.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R653

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