胸、腹腔镜食管癌根治术治疗老年食管癌患者的疗效观察  

Efficacy observation of radical resection on esophageal carcinoma by laparoscopic and thoracoscopic surgery in treatment of elderly patients with esophageal cancer

作　　者：马胡赛[1,2] 蔡奕欣[1] 张霓[1] 付向宁[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院胸外科,湖北武汉430030 [2]青海红十字医院胸外科,青海西宁810000

出　　处：《现代医学》2015年第1期27-30,共4页Modern Medical Journal

摘　　要：目的:观察胸、腹腔镜食管癌根治术治疗老年食管癌患者的临床疗效及其对肺功能的影响。方法:将197例老年食管癌患者分为2组,对照组(102例)采用传统食管癌切除术治疗,腔镜组(95例)采用胸、腹腔镜食管癌根治术治疗。比较两组患者术中出血量、手术时间、清扫淋巴结数、术后住院时间及术后肺部感染发生率等情况,并检测术前和术后肺功能指标(VC、FEV1.0、MVV)变化。结果:腔镜组手术时间虽然较对照组延长(P<0.05),但术中出血量、术后住院时间及术后肺部感染发生率等均明显少于对照组(P<0.05),且清扫淋巴结数明显多于对照组(P<0.05);两组患者术前肺功能指标(VC、FEV1.0、MVV)比较差异无统计学意义(P>0.05),术后两组患者肺功能指标均明显降低(P<0.05),但腔镜组降低幅度小于对照组(P<0.05)。结论:胸、腹腔镜食管癌根治术治疗老年食管癌患者具有出血少、恢复快、术后并发症少、对肺功能影响较小等优点,值得临床推广应用。Objective： To observe the efficacy of radical resection on esophageal carcinoma by laparoscopic and thoracoscopic surgery in treatment of elderly patients with esophageal cancer and its effects on lung function.Methods： 197 cases of elderly patients with esophageal cancer were divided into two groups,the control group（ n =102） was treated by conventional esophageal resection while the observation group（ n = 95） was applied with radical resection by laparoscopic and thoracoscopic surgery. The intraoperatve blood soss,operative time,number of lymph node dissection,postoperative hospital stay and incidence of postoperative pulmonary infection of two groups were compared,and the preoperative and postoperative pulmonary function（ VC,FEV1. 0,MVV） changes were also detected. Results： Although the operative time for the observation group was longer than that for the control group（ P 〈0. 05）. The blood loss,postoperative hospital stay and the incidence of postoperative pulmonary infection of the observation group were significantly less than those of the control group（ P 〈0. 05）,moreover,the number of cleaning lymph nodes in the observation group was obviously more than that in the control group（ P 〈0. 05）. There was no significant difference between the two groups in terms of preoperative pulmonary function（ VC,FEV1. 0,MVV）（ P 〉0. 05） while the indexes of lung function for both groups were significantly lower after the surgery（ P 〈0. 05）,but the reduced level of observation group was less than that of the control group（ P 〈0. 05）. Conclusion：Radical resection on esophageal carcinoma by laparoscopic and thoracoscopic surgery in treatment of elderly patients with esophageal cancer has many advantages such as less bleeding,faster recovery,fewer complications,less impact on lung function,and it is worthy of clinical application.

关 键 词：食管癌 胸腔镜 腹腔镜 肺功能 

分 类 号：R735.1[医药卫生—肿瘤]