经左胸保留膈肌食管裂孔术式在食管癌手术中的应用  

Application of esophagectomy with diaphragm hiatal preservation in esophageal carcinoma patients

作　　者：张进[1] 杨鲲鹏[1] 张清勇[1] 苏彦河[1] 葛晓晴[1] 侯露[1] 姜礼庆[1] 

机构地区：[1]郑州大学第二附属医院胸外科,郑州450014

出　　处：《河南外科学杂志》2017年第3期9-11,共3页Henan Journal of Surgery

摘　　要：目的探讨经左胸保留膈肌食管裂孔术式在食管癌手术中的应用效果。方法随机接受食管癌手术的68例患者分为2组,每组34例。观察组采用经左胸保留膈肌食管裂孔术式,对照组采用经左胸切开膈肌术式。比较2组手术效果。结果 2组手术时间、术中出血量及术后膈疝发生率差异无统计学意义(P>0.05)。观察组术后肺部感染率低于对照组;术后第7天及1个月的MVV%、FEVl%、FVC%及ΔPaO_2、ΔPaCO_2均优于对照组,差异有统计学意义(P<0.05)。术后3个月2组患者的MVV%、FEVl%、FVC%及ΔPaO_2、ΔPaCO_2差异均无统计学意义(P>0.05)。结论经左胸保留膈肌食管裂孔的食管癌手术,可有效改善患者术后近期的呼吸功能,减少术后肺部感染率。Objective To investigate the application of esophagectomy with diaphragm hiatal preservation in esophageal carcinoma pa- tients. Methods Totally 68 esophageal carcinoma patients were divided into 2 groups, Each group 34 cases, observation group received esophageetomy with diaphragm hiatal and control group received esophagectomy. The pulmonary function and blood gas were measured on the 7th day, 1 st month and 3rd month after the operation. And the time of operation, the intra -operative bleeding, the cases of postoperative diaphragmatic hernia and pulmonary infection were also recorded respectively. Results There was no significant difference between the 2 groups in operation time, intraoperative blood loss and postoperative diaphragmatic hernia （ P 〉 0.05 ）. The postoperative infection rate of the observation group was lower than that of the control group;The differences between the 2 groups in the pulmonary function （MVV% ,FEV1% ,FVC% ） , the APaO2 and APaCO2 on 7th day and 1 st month after the operation were significant（ P 〈 0.05 ）. The differences between the 2 groups in the pul- monary function（ MVV% ,FEV1% ,FVC% ） , the △PaO2 and △PaCO2 on 3rd month after the operation were not significant（ P 〉 0.05 ）. The cases of postoperative pulmonary infection in the observation group were significantly less than that of control group （ P 〈 0. 05 ）. Conclusion The esophagectomy with diaphragm hiatal preservation can significantly improve the postoperative respiratory function during the perioperative period and reduce the postoperative pulmonary infection rate.

关 键 词：食管癌 保留膈肌食管裂孔 食管癌切除术 

分 类 号：R735.2[医药卫生—肿瘤]