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自发性食管破裂的诊断和治疗(附6例临床报道及文献复习)

Diagnosis and treatment of spontaneous rupture of esophagus(reportd of 6 cases Boerhaave’s syndrome and a review of the literature)

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【作者】 方寅; 于在诚;

【Author】 Fang Yin,Yu Zaicheng Department of Thoracic Surgery,the First People,s Hospital of Wuhu,Anhui Wuhu 241001

【机构】 芜湖市第一人民医院胸外科; 安徽医科大学附属医院胸外科;

【摘要】 目的总结自发性食管破裂(Boerhaave’s syndrome)诊断和治疗的经验。方法对我院治疗的6例自发性食管破裂病例的诊断、治疗、结果进行回顾性分析,并结合文献复习。结果本组病例4例在48h内确诊并手术,2例经手术探查确诊。本组病死率为50%(3/6)。行一期修补术的3例中有2例距发病起过24h,成功2例。结论高度警惕本病并迅速获得全面、准确的发病史是避免误诊、漏诊的关键。诊断主要根据胸片、食管造影及特征性的胸腔引流物。早期诊断和选择合理术式进行治疗是提高本病疗效,降低病死率的关键。

【Abstract】 Objective To summarize the experiments of diagnosis and treatment of spontaneous rupture of esophagus(Boerhaave’s syndrome).Methods To retrospective review and analyze the diagnosis、treatments and results of 6 patients of spontaneous rupture of esophagus treated in our hospital,and connection to review literature.Results Early diagnosis and operation were performed on 4 cases(<48h)of the group and 2 cases were diagnosed from intraoperatively.The mortality rate was 50%(3/6)in our group,3 cases of the patients admitted primary repair 2 cases over 24h,2 were successful.Conclusion A rapid but complete and accurate grasp of history,remaining high alert on the disease is the key to avoid misdiagnosis.The diagnosis can be confirmed or excluded by a chest film,a opacification of the esophagus or characteristic contents in thoracic fluid.Early diagnosis and appropriate surgical treatments are the key to increase the curative effect and reduce the mortality rate.

【关键词】 自发性食管破裂; 诊断; 治疗;
【Key words】 Spontaneous rupture of esophagus; Diagnosis; Treatment;
  • 【文献出处】 安徽医学 ,Anhui Medical Journal , 编辑部邮箱 ,2007年05期
  • 【分类号】R655.4
  • 【被引频次】10
  • 【下载频次】105
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