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目的 分析食管癌、贲门癌根治术中留置纵隔引流管对防治术后并发症的应用价值.方法 行食管癌或贲门癌根治性切除手术(吻合口均位于胸腔内)的病人120例,将120例病人分为研究组和对照组,每组各60例.研究组术中在吻合口下方放置纵隔引流管;对照组未放置纵隔引流管.比较两组病人术后相关并发症指标.结果 两组均顺利完成手术.研究组和对照组的术后胸腔总引流量分别为(732.67±57.330ml和(572.76±6.77)ml,两组比较差异有统计学意义(P＜0.05);研究组纵隔引流管的引流量为(594.75 ±30.61)ml,约占胸腔总引流量的70.0％;研究组胸腔闭式引流管的平拔除时间为(5.82 ±0.90)天,对照组为(5.47±0.95)天,两组比较差异无统计学意义(P＞0.05);研究组术后平均最高体温为(37.81 ±0.76)℃,对照组为(38.53 ± 0.45)℃,术后平均白细胞计数峰值分别为(14.52±1.22×109/L)和(16.49±1.19×109/L),两组比较差异有统计学意义(P＜0.05);研究组术后对侧胸腔积液行穿刺引流5例,对照组16例,两组比较差异有统计学意义(P＜0.05).两组术后吻合口漏发生率、出院后半年吻合口狭窄率比较,差异无统计学意义(P＞0.05);两组吻合口漏确诊时间、术后心肺并发症发生率、吻合口漏所致病死率、吻合口漏治愈时间比较,差异有统计学意义(P＜0.05).结论 术中放置纵隔引流管虽然不能降低食管癌、贲门癌切除术后胸内吻合口漏的发生率,但是能更好地通畅术后胸腔引流、降低对侧胸腔积液发生率,减轻术后全身炎症反应症状,有助于术后早期发现吻合口漏,减少心肺并发症的发生,缩短吻合口漏的治愈时间,降低吻合口漏所致死亡率.但对术后出现吻合口狭窄与否无明显影响.“,”Objective To investigate the value of mediastinal drainage tube for the prevention and treatment of complications after radical operation for esophogas and cardia cancers. Methods Totally 120 patients with esophageal or cardia cancer were randomly divided into study group(preset mediastinal drainage tube, n =60)and control group(no preset mediastinal drainage tube, n =60). Patients with gastric cardia or esophageal cancer were underwent gastroesophageal intrathoracic anastomosis by left chest surgical approach. Meanwhile, patients with middle esophageal cancer were subjected to intrathoracic esophagogastric anastomosis by right chest surgical approach. Clinical indicators after surgery in the two groups were recorded. Results The postoperative variations on total volume of thoracic drainage, mean maximum temperature, mean maximum leukocyte counts, number of patients with hydrothorax in contralateral lung needed to puncture and drainage, number of patients suffered cardiopulmonary complication, period of time when anastomotic leakage was confirmed, fatality rate contributed by anastomotic leakage and period of time took for recovery from anastomotic leakage were statistically significant(P＜0.05) between. the two groups. The postoperative variations on period of time with closed thoracic drainage tube, number of patients complicated with anastomotic leakage, number of patients suffered from anastomotic strictures at 6 months after surgery were not statistically significant(P＞ 0.05) between the two groups. The volume of mediastinal drainage tube accounted for about 70％ of the total volume of thoracic drainage in the study group. Conclusion Placing a mediastinal drainage tube in radical operation for esophogas and cardia cancer cant prevent gastroesophageal anastomotic leakage, but it is valuable for early diagnosis and treatment of anastomotic leakage as well as shortening the recovery course of anastomotic leakage, and reducing mortality caused by anastomotic leakage. However, there is no obvious effect on postoperative anastomotic stenosis.