持续封闭负压引流处理咽瘘的效果观察

Effect of continuous sealing negative pressure drainage in the treatment of pharyngeal fistula

摘要:

【摘要】 目的 评估持续封闭负压引流处理咽瘘的效果。方法 回顾性分析2019年6月至2021年11月于山东省立医院耳鼻咽喉头颈外科因喉癌、下咽癌、下咽癌合并食管癌、颈段食管癌行肿瘤切除并咽部直接吻合修补或使用组织瓣、管状胃、游离空肠等行咽部修复的患者117例，其中咽瘘者18例。均采用持续封闭负压引流方式处理咽瘘。采用描述性统计学方法分析其治疗过程及术后疗效。结果 18例咽瘘患者中，发现咽瘘时间为术后第4-26天（中位时间9天），咽瘘持续时间为10-52天（中位时间20天），所有咽瘘患者咽瘘口均以此方法保守治疗愈合，均无需再行手术修补。结论 持续封闭负压引流可减轻咽瘘患者痛苦、减少医师换药操作时间、缩短咽瘘持续时间，减少咽瘘发展至手术修补的几率。

Abstract:

[Abstract] Objective: To evaluate the effect of continuous closed negative pressure drainage in the treatment of pharyngeal fistula.Methods:A retrospective analysis was made of 117 patients who underwent tumor resection and pharyngeal direct anastomosis repair or pharyngeal repair with tissue flap, tubular stomach and free jejunum in the Department of Otolaryngology Head and neck surgery of Shandong provincial hospital from June 2019 to November 2021, including 18 cases of pharyngeal fistula. All patients were treated with continuous closed negative pressure drainage. The treatment process and postoperative efficacy were analyzed by descriptive statistics.Results:Among the 18 patients with pharyngeal fistula, the time of pharyngeal fistula was found to be 4-26 days after operation (median time 9 days), and the duration of pharyngeal fistula was 10-52 days (median time 20 days). All patients with pharyngeal fistula healed conservatively with this method, and there was no need for surgical repair.Conclusion:Continuous closed negative pressure drainage can reduce the pain of patients with pharyngeal fistula, reduce the dressing change operation time of doctors, shorten the duration of pharyngeal fistula, and reduce the probability of pharyngeal fistula developing to surgical repair.