【摘要】目的：探讨食管贲门癌术后胸内吻合口瘘的外科治疗。方法：2001年01月至2010年06月手术治疗胸下段食管贲门癌264例，均为胸内吻合，发生食管胃吻合口瘘8例，发生率3.3%。对该8例食管胃吻合口瘘患者均行开胸探查冲洗、重新置胸管充分引流、常规气管切开呼吸机辅助呼吸以及空肠造瘘肠内营养，并给予抗感染、静脉营养、持续胃肠减压治疗。结果：治愈7例，1例瘘口经胸腔与胸壁形成窦道，二次术后32天死于肺部霉菌感染。结论：对于早中期食管贲门癌术后胸内吻合口瘘，积极开胸冲洗并重新置管确保胸腔引流通畅，常规气管切开呼吸机辅助呼吸以及空肠造瘘肠内营养是有效的治疗方法。

    【关键词】食管贲门癌；吻合口瘘；治疗

    Cardiac thoracic esophageal anastomotic leakage within the clinical treatment of patients

    【Abstract】Objective: To investigate cardiac thoracic esophageal anastomotic fistula in surgical treatment. Methods: from January 2001 to June 2010 thoracic surgical treatment of esophageal and cardiac carcinoma 264 cases are intrathoracic anastomosis, anastomotic leakage occurred esophagus in 8 cases, the incidence of 3.3%. The 8 patients with esophageal and gastric fistula patients underwent thoracotomy washing, re-set the full chest tube drainage, and conventional mechanical ventilation with tracheotomy and ostomy jejunal enteral nutrition, and to give antibiotics, parenteral nutrition, continuous stomach intestinal decompression treatment. Results: 7 patients were cured, 1 case of pleural and chest wall fistula formation by sinus, 32 days after the second died of pulmonary fungal infection. Conclusion: For the early and mid-cardiac thoracic esophageal anastomotic leakage within the active washing and re-thoracotomy chest tube drainage to ensure the smooth, conventional mechanical ventilation with tracheotomy and ostomy jejunal enteral nutrition is an effective treatment method. ......