SELECTIVE NONOPERATIVE MANAGEMENT OF CONTAINED INTRA-THORACIC ESOPHAGEAL DISRUPTIONS
SELECTIVE NONOPERATIVE MANAGEMENT OF CONTAINED INTRA-THORACIC ESOPHAGEAL DISRUPTIONS
复制标题
DOI：
10.1016/s0003-4975(10)63335-8
复制
发表时间：
1979-01-01
影响因子：
4.6
通讯作者：
BAKER, RR
中科院分区：
文献类型：
--
作者：
CAMERON, JL;KIEFFER, RF;BAKER, RR
8例胸内食管破裂患者采用非手术治疗，无需胸腔引流。非手术治疗的标准包括：纵隔内或纵隔与肺胸膜脏层之间的破裂;腔引流回食管;最小症状;以及最小临床脓毒症体征。食管穿孔的原因是充气扩张（1例患者）、呕吐（2例）和食管手术后泄漏（5例）。所有患者均静脉注射抗生素，5例静脉注射高营养，仅1例使用鼻胃吸引。在所有情况下，腔体收缩，食管泄漏密封。恢复经口给药前的时间范围为7至38天（平均18天）。至出院的天数范围为15至52天（平均28天）。
Eight patients with intrathoracic esophageal disruptions were managed nonoperatively and without pleural drainage. Criteria for nonoperative treatment included the following: disruption contained in the mediastinum or between the mediastinum and visceral lung pleura; drainage of the cavity back into the esophagus; minimal symptoms; and minimal signs of clinical sepsis. Cause of the esophageal perforation was pneumostatic dilatation (1 patient), vomiting (2), and a leak following esophageal operation (5). Antibiotics were administered intravenously to all patients; hyperalimentation was accomplished intravenously in 5, and nasogastric suction was used in only 1. The cavities contracted and the esophageal leaks sealed in all instances. Time before oral intake was resumed ranged from 7 to 38 days (average, 18 days). Days until discharge ranged from 15 to 52 days (average, 28 days).