不同根治术后患者围手术期并发症的发生率及机体创伤应激反应程度比较  

Comparison of the incidence rates of postoperative complications and the degree of traumatic stress response of patients between thoracoscopic radical resection of esophageal carcinoma and open radical resection of esophageal carcinoma

作　　者：熊秀娥[1] 徐鹏[2] 庞一雄[1] 朱琳燕[3] 

机构地区：[1]武汉科技大学附属孝感医院心胸整复科,湖北省孝感市432000 [2]武汉科技大学附属孝感医院CT室,湖北省孝感市432000 [3]鄂东医疗集团黄石市中心医院(湖北理工学院附属医院)肿瘤内科

出　　处：《河北医药》2017年第23期3554-3556,共3页Hebei Medical Journal

基　　金：项目来源:黄石市科学技术局(编号:黄科技发农【2015】3号)

摘　　要：目的探讨胸腔镜食管癌根治术与开放食管癌根治术后患者围手术期并发症的发生率以及机体应激反应程度比较。方法选取2015年8月至2016年10月接受治疗的食管癌患者90例,采用随机数表法将患者分为观察组和对照组,每组45例。对照组患者给予开放食管癌根治术治疗,观察组患者给予胸腔镜食管癌根治术治疗,观察比较2组患者的手术情况,治疗后并发症发生率情况以及机体应激反应情况。结果观察组患者治疗后,急性呼吸窘迫、心律失常、心力衰竭、脑梗死、肾功能不全、肝功能不全、肺部感染以及肺不张等并发症发生率低于对照组患者,2组比较差异有统计学意义(P<0.05);观察组患者的术中出血量(132.45±21.03)ml低于对照组(145.78±22.89)ml,观察组患者的手术时间(68.45±15.89)min以及术后住院时间(9.78±2.56)d短于对照组[(78.56±18.39)min、(13.12±3.89)d],2组比较差异有统计学意义(P<0.05);治疗后,2组患者的白细胞计数、血清皮质醇以及C-反应蛋白与治疗前比较都有所升高,治疗前后比较差异有统计学意义(P<0.05);2组患者治疗前甲状腺素比较,差异无统计学意义(P>0.05);治疗后,2组患者FT3、FT4与治疗前进行比较都有所升高,2组患者治疗前后比较差异无统计学意义(P<0.05)。结论胸腔镜食管癌根治术治疗食管癌患者,能够有效的降低并发症发生率,对机体应激反应无明显影响。Objective To investigate and compare the incidence rates of postoperative complications and the degree of traumatic stress response of patients between thoracoscopic radical resection of esophageal carcinoma and open radical resection of esophageal carcinoma. Methods Ninety patients with esophageal cancer who were admitted and treated in our hospital from August 2015 to October 2016 were randomly divided into observation group and control group,with 45 patients in each group. The patients in control group were treated by open radical resection of esophageal carcinoma,however,the patients in observation group were treated by thoracoscopic radical resection of esophageal carcinoma,then the operation condition,incidence rates of postoperative complications and the degree of traumatic stress response were observed and compared between two groups. Results After treatment,the incidence rates of postoperative complications including acute respiratory distress,arrhythmia,heart failure,cerebral infarction,renal insufficiency,liver dysfunction,pulmonary infection and atelectasis in observation group were significantly lower than those in control group（ P 〈 0. 05）. The intraoperative bleeding volume[（ 132. 45 ± 21. 03） ml]in observation group were lower than that [（ 145. 78 ± 22. 89） ml] in control group,moreover the operation time [（ 68. 45 ± 15. 89） min] and postoperative hospitalization time [（ 9. 78 ± 2. 56） d] in observation group were significantly shorter than those [（ 78. 56 ± 18. 39） min,（ 13. 12 ± 3. 89） d,respectively] in control group（ P 〈 0. 05）. After treatment,the levels of white blood cell count,serum levels of cortisol and C reactive protein（ CRP） were significantly increased,as compared with those before treatment（ P 〈 0. 05）,however,there were no significant differences in the levels of thyroid hormone between two groups（ P 〉 0. 05）. Moreover the levels of FT3,FT4 in both groups were increased after treatment,however,there were no significant diffe

关 键 词：胸腔镜食管根治术 应激反应 开放食管癌根治术 

分 类 号：R735.1[医药卫生—肿瘤]