胸腔镜根治术对老年食管癌患者术后肺部感染与呼吸功能及炎症因子影响  

Effect of thoracoscopic radical resection on postoperative pulmonary infection,respiratory function and inflammatory factors in elderly patients with esophageal cancer

作　　者：朱应超 李翠翠 尹波[1] 张磊[1] 李大宏[1] 刘相燕[3] ZHU Ying-chao;LI Cui-cui;YIN Bo;ZHANG Lei;LI Da-hong;LIU Xiang-yan(Laiwu People's Hospital,Laiwu,Shandong 271199,China)

机构地区：[1]莱芜市人民医院胸心外科,山东莱芜271199 [2]莱芜市人民医院干部科,山东莱芜271199 [3]山东省立医院胸外科,山东济南250021

出　　处：《中华医院感染学杂志》2018年第24期3784-3787,共4页Chinese Journal of Nosocomiology

摘　　要：目的分析胸腔镜根治术对老年食管癌患者术后肺部感染与呼吸功能及炎症因子影响。方法选取2016年6月-2017年6月于医院行手术治疗的老年食管癌患者122例,依据随机数字表法将其分为对照组与试验组,各61例。对照组患者行传统食管癌根治手术,试验组患者行胸腹腔镜食管癌根治手术;观察两组患者住院时间、手术中出血量、手术时间及术后肺部并发症,ELISA法检测血清超敏C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)含量,使用肺功能检测仪对手术前后患者用力肺活量(FVC)和第一秒用力呼气量(FEV1)进行检测。结果试验组患者住院时间、手术中出血量及手术时间均低于对照组患者(P<0.05);手术后,两组患者血清hs-CRP、IL-6及TNF-α含量均较手术前升高(P<0.05),试验组升高幅度低于对照组(P<0.05);两组患者FVE1和FVC均较治疗前降低(P<0.05),试验组降低幅度低于对照组(P<0.05);对照组患者肺部感染发生率为16.39%,高于试验组患者的6.56%(P<0.05)。结论胸腹腔镜根治手术对老年食管癌患者呼吸功能影响较小,可有效降低患者手术后血清炎症因子含量和肺部感染等并发症。OBJECTIVE To analyze the effects of thoracoscopic radical resection on postoperative pulmonary infection,respiratory function and inflammatory factors in elderly patients with esophageal cancer.METHODS A total of 122 elderly patients with esophageal cancer who underwent surgery in the hospital from Jun.2016 to Jun.2017 were enrolled,and divided into the control group and the experimental group according to the random number table method,with 61 cases in each group.The patients in the control group underwent traditional radical resection of esophageal cancer.The patients in the experimental group underwent thoracoscopic radical resection of esophageal cancer.The length of hospital stay,the amount of bleeding during operation,the operation time and postoperative pulmonary complications were observed in the two groups.Serum levels of hypersensitive-C-reactive protein(hs-CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were detected by ELISA,the forced vital capacity(FVC)and the first second forced expiratory volume(FEV1)of the patients were determined using pulmonary function tester before and after surgery.RESULTS The hospitalization time,the amount of bleeding during operation and the operation time were significantly lower in the experimental group than in the control group(P<0.05).After operation,the serum levels of hs-CRP,IL-6 and TNF-αin the two groups were significantly higher than those before surgery(P<0.05),and the increase of the experimental group was significantly lower than that of the control group(P<0.05).The FVE1 and FVC of the two groups were lower than those before treatment(P<0.05),and the decrease of the test group was lower than that of the control group(P<0.05).The incidence of pulmonary infection in the control group was 16.39%,which was significantly higher than that in the experimental group(6.56%)(P<0.05).CONCLUSION Thoracoscopic radical resection has little effect on the respiratory function in elderly patients with esophageal cancer,which can effectively reduce the serum infl

关 键 词：老年食管癌 胸腔镜根治术 肺部感染 呼吸功能 炎症因子 

分 类 号：R619.3[医药卫生—外科学]