• 1.四川大學(xué)華西醫(yī)院 胸外科，成都　610041;;
  • 2.甘孜州瀘定縣人民醫(yī)院　外科，四川瀘定　626100;

目的　探討自發(fā)性食管破裂的治療方法，總結(jié)其外科治療經(jīng)驗(yàn)?！》椒ā』仡櫺苑治鋈A西醫(yī)院1998年1月至2011年12月14例自發(fā)性食管破裂患者的臨床資料，其中男11例，女3例；年齡（55.2±14.4）歲；發(fā)病時(shí)間（49.6±21.2）h。行Ⅰ期修補(bǔ)術(shù)11例，消化道重建術(shù)1例，安置可取出式食管帶膜支架1例；行床旁胸腔閉式引流術(shù)1例?！〗Y(jié)果　13例患者行手術(shù)治療，總體治愈率84.6% （11/13）。行Ⅰ期修補(bǔ)術(shù)11例中8例（72.7%）治愈，術(shù)后發(fā)生瘺3例，其中2例死亡，另1例治愈，住院時(shí)間（22.3±7.0） d。行消化道重建術(shù)和安置可取出式食管帶膜支架的2例均痊愈，住院時(shí)間（39.0±5.7）d。1例僅行床旁胸腔閉式引流術(shù)，住院10 d后死亡?！〗Y(jié)論　積極的外科治療是自發(fā)性食管破裂的有效方法，發(fā)病時(shí)間超過(guò)24 h仍可依據(jù)術(shù)中情況行Ⅰ期修補(bǔ)術(shù)，無(wú)Ⅰ期修補(bǔ)指征者可以行消化道重建術(shù)、安置帶膜食管支架或食管腔內(nèi)置管術(shù)。

引用本文： 林一丹,蔣光亮,劉倫旭,陳龍奇,高向義. 自發(fā)性食管破裂14例的診斷與治療. 中國(guó)胸心血管外科臨床雜志, 2012, 19(5): 472-475. doi: 復(fù)制

1. 　Mahmodlou R, Abdirad I, Ghasemi-Rad M. Aggressive surgical treatment in late-diagnosed esophageal perforation：a report of 11 cases. ISRN Surg, 2011, 2011：868356.
2. 　Zhou JH, Gong TQ, Jiang YG, et al. Management of delayed intrath　oracic esophageal perforation with modified intraluminal esophageal stent. Dis Esophagus, 2009, 22 （5）： 434-438.
3. 　Griffiths EA, Yap N, Poulter J, et al. Thirty-four cases of esophageal perforation： the experience of a district general hospital in the UK. Dis Esophagus, 2009, 22 （7）： 616-625.
4. 　Foley MJ, Ghahremani GG, Rogers LF. Reappraisal of contrast　media used to detect upper gastrointestinal perforations： comparison of Ionic water-soluble media with Barium sulfate. Radiology, 1982, 144 （2）： 231-237.
5. 　Carrott PW Jr, Low DE. Advances in the management of esophageal perforation. Thorac Surg Clin, 2011, 21 （4）： 541-555.
6. 　Skinner DB, Little AG, Demeester TR. Management of esophageal perforation. Am J Surg, 1980, 139 （6）： 760-764.
7. 　Wang Y, Zhang R, Zhou Y, et al. Our experience on management of Boerhaave’s syndrome with late presentation. Dis Esophagus, 2009, 22 （1）： 62-67.
8. 　Gupta NM, Kaman L. Personal management of 57 consecutive　patients with esophageal perforation. Am J Surg, 2004, 187 （1）： 58-63.
9. 　Sung SW, Park JJ, Kim YT, et al. Surgery in thoracic esophageal perforation： primary repair is feasible. Dis Esophagus, 2002, 15 （3）： 204-209.
10. 　Eroglu A, Turkyilmaz A, Aydin Y, et al. Current management of　esophageal perforation： 20 years experience. Dis Esophagus, 2009, 22 （4）： 374-380.
11. 　Wang N, Razzouk AJ, Safavi A, et al. Delayed primary repair of intrathoracic esophageal perforation：is it safe? J Thorac Cardiovasc Surg, 1996, 111 （1）： 114-122.
12. 　Henne TH, Schaeff B, Paolucci V. Small-bowel obstruction and perforation. A rare complication of an esophageal stent.Surg Endosc, 1997, 11 （4）： 383-384.
13. 　Minnich DJ, Yu P, Bryant AS, et al. Management of thoracic esophageal perforations. Eur J Cardiothorac Surg, 2011, 40 （4）： 931-937.
14. 　Qadir I, Zafar H, Khan MZ, et al. T-tube management of late esophageal perforation. J Pak Med Assoc, 2011, 61 （4）： 418-420.
15. 　Nakabayashi T, Kudo M, Hirasawa T, et al. Successful late management of esophageal perforation with T-tube drainage. Case Rep　Gastroenterol, 2008, 2 （1）： 67-70.
  1. 1. 　Mahmodlou R, Abdirad I, Ghasemi-Rad M. Aggressive surgical treatment in late-diagnosed esophageal perforation：a report of 11 cases. ISRN Surg, 2011, 2011：868356.
  2. 2. 　Zhou JH, Gong TQ, Jiang YG, et al. Management of delayed intrath　oracic esophageal perforation with modified intraluminal esophageal stent. Dis Esophagus, 2009, 22 （5）： 434-438.
  3. 3. 　Griffiths EA, Yap N, Poulter J, et al. Thirty-four cases of esophageal perforation： the experience of a district general hospital in the UK. Dis Esophagus, 2009, 22 （7）： 616-625.
  4. 4. 　Foley MJ, Ghahremani GG, Rogers LF. Reappraisal of contrast　media used to detect upper gastrointestinal perforations： comparison of Ionic water-soluble media with Barium sulfate. Radiology, 1982, 144 （2）： 231-237.
  5. 5. 　Carrott PW Jr, Low DE. Advances in the management of esophageal perforation. Thorac Surg Clin, 2011, 21 （4）： 541-555.
  6. 6. 　Skinner DB, Little AG, Demeester TR. Management of esophageal perforation. Am J Surg, 1980, 139 （6）： 760-764.
  7. 7. 　Wang Y, Zhang R, Zhou Y, et al. Our experience on management of Boerhaave’s syndrome with late presentation. Dis Esophagus, 2009, 22 （1）： 62-67.
  8. 8. 　Gupta NM, Kaman L. Personal management of 57 consecutive　patients with esophageal perforation. Am J Surg, 2004, 187 （1）： 58-63.
  9. 9. 　Sung SW, Park JJ, Kim YT, et al. Surgery in thoracic esophageal perforation： primary repair is feasible. Dis Esophagus, 2002, 15 （3）： 204-209.
  10. 10. 　Eroglu A, Turkyilmaz A, Aydin Y, et al. Current management of　esophageal perforation： 20 years experience. Dis Esophagus, 2009, 22 （4）： 374-380.
  11. 11. 　Wang N, Razzouk AJ, Safavi A, et al. Delayed primary repair of intrathoracic esophageal perforation：is it safe? J Thorac Cardiovasc Surg, 1996, 111 （1）： 114-122.
  12. 12. 　Henne TH, Schaeff B, Paolucci V. Small-bowel obstruction and perforation. A rare complication of an esophageal stent.Surg Endosc, 1997, 11 （4）： 383-384.
  13. 13. 　Minnich DJ, Yu P, Bryant AS, et al. Management of thoracic esophageal perforations. Eur J Cardiothorac Surg, 2011, 40 （4）： 931-937.
  14. 14. 　Qadir I, Zafar H, Khan MZ, et al. T-tube management of late esophageal perforation. J Pak Med Assoc, 2011, 61 （4）： 418-420.
  15. 15. 　Nakabayashi T, Kudo M, Hirasawa T, et al. Successful late management of esophageal perforation with T-tube drainage. Case Rep　Gastroenterol, 2008, 2 （1）： 67-70.