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目的:明确食管癌术后健侧胸腔积液的易患因素,探讨针对性的防治经验。方法:对448例食管癌手术患者的一般资料、术式、病理特征、预后进行回顾性研究。结果:全组18例(4.0%)患者发生健侧胸腔积液。采取颈部吻合者发生率显著低于胸腔内吻合者(P=0.032),淋巴结清扫范围增大则显著增加发生率(P=0.042)。发生健侧胸腔积液者ICU天数显著增加(P<0.001)。结论:保持健侧胸膜完整、减少胸腔内污染,可以降低术后健侧胸腔积液发生率。颈部吻合方式能有效避免该并发症。一旦发生,要尽早作出诊断,加强止痛,积极防治继发呼吸衰竭。
Objective: To identify the risk factors of pleural effusion after esophageal cancer surgery, and to explore the specific prevention and treatment experience. Methods: A retrospective study was conducted on the general data, surgical procedures, pathological features and prognosis of 448 esophageal cancer patients. Results: Pleural effusion occurred in 18 patients (4.0%) in the whole group. The incidence of cervical anastomosis was significantly lower than that of intrathoracic anastomosis (P = 0.032). The increased lymph node dissection increased the incidence significantly (P = 0.042). The number of ICU days was significantly increased in patients with contralateral pleural effusion (P <0.001). Conclusion: To maintain the integrity of the contralateral pleura and reduce the intrathoracic contamination, can reduce the incidence of postoperative contralateral pleural effusion. Neck anastomosis can effectively avoid the complications. In the event of an early diagnosis, strengthen pain relief and prevent secondary respiratory failure.