经内镜医用生物蛋白胶治疗食管癌术后吻合口瘘的疗效观察.doc

经内镜医用生物蛋白胶治疗食管癌术后吻合口瘘的疗效观察
作者:姚文健白玉赵国昌王永连王忠民
【摘要】目的探讨医用生物蛋白胶(fibrin glue ,FG)封堵治疗食管癌术后胸内吻合口瘘的效果。方法将38 例患者随机分为观察组与对照组,均为胸内吻合口瘘,18 例应用FG 经胃镜进行封堵瘘口治疗,20 例保守治疗。结果观察组平均愈合时间为41±8 天,对照组平均愈合时间为58±6 天,两组愈合时间差异有显著性(p<)。结论与常规保守治疗比较,内镜下FG 封堵治疗吻合口瘘具有创伤小、封闭准确迅速、操作简便、费用低、效果好等特点,适宜于在临床上推广应用。
【关键词】医用生物蛋白胶;封堵;食管瘘;内镜
[Abstract] Objective To explore the effect of FG in treating anastomotic fistula after operation of esophageal arcinoma. Methods 38 patients with anastomotic fistul are randomly divided into the observed group and the control group. 18 cases were occluded with FG under gastroscope. 20 were treated conservatively. Results The average recover time of observed group was 41±8 days, the control group was 58±6 days,.The difference was very significant (P<). pared to the conventional conservative treatment,occlusion with FG for esophageal fistula under endoscope had the advantages of minimally-invasive, lower expense, simple and ca
n be applied safely widely to clinical.
[Key words] fibrin glue; occlusion; esophageal fistula; endoscopy
食管癌术后并发胸内吻合口瘘是一种严重的并发症,发生率为3%~5%,病死率达50%[1,2]。传统的处理方法是根据病情,再次开胸探查或采用保守治疗,近年来各种预防和减少吻合口瘘的方法时有报道, 包括再手术、保守治疗、内镜下治疗、放置支架及全身对症支持治疗等[3]。我院自2006 年6月~2010 年8 月对18 例胸内吻合口瘘的患者在内镜下应用医用生物蛋白胶封堵瘘口取得了较好的
疗效,现报道如下。
1 临床资料
一般资料
应用随机分组方法,将同期38 例患者分为观察组与对照组,均为胸内吻合口瘘,发生于术后3~15d,通过碘剂造影确诊。观察组18 例,其中男11例,女7 例;年龄39~72 岁, 岁。