胸腹腔镜微创手术与传统开胸手术对食管癌患者术后肺功能、炎症因子水平的影响  

Effect of minimally invasive laparoscopic surgery and conventional thoracotomy on lung function and inflammatory factors after operation in patients with esophageal cancer

作　　者：曾新敏[1] 王晖[1] 章志龙[1] 胡火利[1] 徐兴华[1] 陈华[1] 

机构地区：[1]江西省南昌市第一医院,江西南昌330008

出　　处：《中国当代医药》2016年第29期79-81,110,共4页China Modern Medicine

摘　　要：目的探讨胸腹腔镜微创手术与传统开胸手术对食管癌患者术后肺功能、炎症因子水平的影响。方法 将2012年8月~2015年12月于我院确诊为食管癌行手术治疗的90例患者纳入研究,依据手术方案分为传统开胸术组（n=44）及胸腹腔镜微创手术组（n=46）。观察两组患者术前及术后30 d用力肺活量占预计值比例（FEV%）、第一秒用力呼气量占预计值比例（FEV1%）、用力呼气量占预计值比例（FVC%）等指标改善情况,观察两组术后第1天及第7天时TNF-α、IL-8、IL-6等炎症因子变化情况。结果 术后30 d,传统开胸组FEV%、FEV1%、FVC%水平分别为（72.16±8.42）%、（70.47±6.32）%、（68.05±7.62）%,胸腹腔镜微创手术组则分别为（76.43±5.35）%、（76.78±5.35）%、（73.25±6.48）%,两组FEV%、FEV1%、FVC%较术前均下降,但胸腹腔镜微创手术组改善更显著（P〈0.05）;术后第7天传统开胸组TNF-α、IL-8、IL-6水平分别为（3.88±0.49）、（3.37±0.76）、（2.58±0.53）ng/ml,胸腹腔镜微创手术组则分别为（2.23±0.28）、（2.34±0.51）、（1.91±0.27）ng/ml,两组TNF-α、IL-8、IL-6术后第1天均降低,但胸腹腔镜微创手术组改善更显著（P〈0.05）。结论 胸腹腔镜微创手术与传统开胸术相比,具有创伤小的优势,可更好地预防肺功能损伤,值得推广。Objective To investigate the effect of minimally invasive laparoscopic surgery and traditional thoracotomy on pulmonary function and inflammatory factors after operation in patients with esophageal cancer.Methods Patients with esophageal cancer diagnosed and underwent surgical treatment in our hospital from August 2012 to December 2015 were enrolled in the study and divided into conventional thoracotomy group （n=44） and laparoscopic minimally invasive surgery group （n=46） according to the operation plan.Improvement of forced vital capacity accounted for the proportion of expected value （FEV%）,forced expiratory volume in the first second proportion of expected value （FEV,%）,forced ex- piratory volume accounted for the proportion of expected value （FVC%） preoperative and postoperative 30 days were compared,TNF-α,IL-8 and IL-6 levels of inflammatory cytokine on the first day and on the seventh day were observed. Results The level of FEV% ,FEV1% ,FEV% postoperative 30 d in the conventional thoracotomy group was （72.16± 8.42）%,（70.47±6.32）%,（68.05±7.62）% respectively,and （76.43±5.35）%,（76.78±5.35）%,（73.25±6.48）% respectively in the laparoscopic minimally invasive surgery group,FEV%,FEVI%,FVC% of two groups were all decreased,but the improve- ment of laparoscopic minimally invasive surgery was more significant （P〈0.05）.The level of TNF-a,IL-8,IL-6 on the seventh day in the conventional thoracotomy group was （3,88±0.49）,（3.37±0.76）,（2.58±0.53）ng/ml respectively,（2.23± 0.28）,（2.34±0.51）,（1.91±0.27）ng/ml respectively in the laparoscopic minimally invasive surgery group,TNF-α,IL-8,IL-6 of two groups were all decreased than that on the first day,but the improvement of the laparoscopic minimally invasive surgery group was more significant （P〈0.05）.Conclusion Compared with conventional thoracotomy,laparoscopie minimal- ly invasive surgery has advantages of less trauma,better prevention of lung function,and it is worth popularizing.

关 键 词：胸腹腔镜微创手术 传统开胸手术 食管癌 肺功能 炎症因子 

分 类 号：R735.1[医药卫生—肿瘤]