Ivor-Lewis 术式对老年食管癌患者肺功能和生活质量的影响  

Impact of Ivor-Lewis surgery on lung function and quality of life of elderly patients with esophageal cancer

作　　者：王东涛[1] 贺钢枫[2] 杨瑜 

机构地区：[1]包头市中心医院胸外科(包头医学院2012级研究生),内蒙古自治区包头014040 [2]包头市中心医院胸外科,内蒙古自治区包头014040 [3]中国兵器北方重工集团医院内分泌科

出　　处：《中国基层医药》2014年第20期3081-3083,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：探讨Ivor-Lewis术式对老年食管癌患者肺功能和生活质量的影响。方法将122例老年食管癌患者按照数字表法随机分为观察组和对照组各61例。对照组采用Sweet 手术，观察组采用Ivor-Lewis手术。观察两组手术时间、术中出血量、淋巴结清扫数、引流量及住院时间。比较两组患者术后3 d肺功能和术后3个月的生活质量。结果观察组手术时间、术中出血量、引流量及住院时间[（162．4±30．4）min，（260．1±33．7） mL，（1254．1±311．2） mL，（11．2±3．1） d]均少于对照组[（201．6±33．6） min，（315.2±41．3）mL，（1928．3±346．1）mL，（17．6±3．6）d]（t＝3．627、4．662、2．716、3．772，均P＜0．05），淋巴结清扫数[（36．1±7．7）枚]多于对照组[（21．6±7．1）枚]（t＝9．062，P＜0．05）。两组治疗前第1秒用力呼气容积（FEV1）、用力吸气肺活量（FVC）、最大呼气流量（PEF）差异无统计学意义（t＝0．612、0．301、0．772，均P＞0．05），对照组和观察组治疗3 d后FEV1分别为（1．89±0．47） L、（2．18±0．42） L；FVC分别为（2．44±0.31）L、（2．87±0．25）L；PEF分别为（4．01±0．26）L/s、（4．52±0．29）L/s。对照组治疗3 d后患者FEV1、FVC和PEF均明显降低（t＝4．162、3．997、5．012，均P＜0．05），观察组FEV1、FVC术前和术后3 d差异均无统计学意义（t＝1．032、0．924，均P＞0．05），观察组治疗3 d后PEF明显降低（t＝3．128，P＜0．05）。治疗3 d后，观察组FEV1、FVC和PEF明显高于对照组（t＝5．186、3．017、3．112，均P＜0．05）。对照组和观察组术前生活质量评分分别为（5．41±1．83）分和（5．31±1．77）分；术后分别为（7．01±2．16）分和（8．35±2．27）分。两组患者手术后生活质量均较术前提高，并且观察组较对照组提高更明显（t＝2．864，P＜0.05）。结论 Ivor-Lewis术式可以明�Objective To study the influence of Ivor-Lewis surgery on lung function and quality of life of elderly patients with esophageal cancer .Methods 122 elderly patients with esophageal cancer were randomly divided into the observation group and the control group ,61 cases in each group .The control group was given Sweet surgery , observation group was given Ivor-Lewis surgery.The operative time,blood loss,number of lymph node dissection , drainage and hospitalization time were observed .Postoperative lung function 3 days after operation and life quality of patients 3 months after operation were compared between the two groups .Results The operative time,blood loss, drainage,and hospital stay in the observation group were （162.4 ±30.4） min,（260.1 ±33.7） mL,（1 254.1 ± 311.2）mL,（11.2 ±3.1）d,which were significantly lower than （201.6 ±33.6）min,（315.2 ±41.3）mL,（1 928.3 ± 346.1）mL,（17.6 ±3.6）d in the control group （t=3.627,4.662,2.716,3.772,all P〈0.05）.The number of lymph node dissection in the observation group was more than the control group （t=9.062,P〈0.05）.Before treat-ment,FEV1,FVC and PEF had no significant differences （t=0.612,0.301,0.772,all P〉0.05）.After treatment for 3 days,FEV1 of the control group and observation group were （1.89 ±0.47）L,（2.18 ±0.42）L;FVC were （2.44 ± 0.31）L,（2.87 ±0.25）L.PEF were （4.01 ±0.26）L/s,（4.52 ±0.29）L/s.After treatment for 3 days,FEV1,FVC and PEF in the control group were significantly decreased （t=4.162,3.997,5.012,all P〈0.05）.In the observation group,FEV1,FVC before and postoperative 3 days had no significant differences （t=1.032,0.924,all P〉0.05）, 3 days after treatment,PEF of the observation group was significantly decreased （t=3.128,P〈0.05）.After treat-ment for 3 days,FEV1 ,FVC and PEF of the observation group were significantly higher than those of the control group （t=5.186,3.017,3.112,P〈0.05）.Before surgery,scores of life quality in the control group and observation g

关 键 词：食管肿瘤 手术方式 肺功能 生活质量 

分 类 号：R735.1[医药卫生—肿瘤]