手术治疗稳定期肺结核并发食管下段癌的效果分析  

Analysis on the effect of surgical treatment for stable pulmonary tuberculosis associated with lower esophageal carcinoma

作　　者：林存红 

机构地区：[1]山东省泰安市肿瘤(结核病)防治院外一科,271000

出　　处：《中国防痨杂志》2018年第3期280-285,共6页Chinese Journal of Antituberculosis

摘　　要：目的探讨手术治疗稳定期肺结核并发食管下段癌的可行性和安全性。方法收集2009年3月至2014年3月泰安市肿瘤（结核病）防治院收治的34例稳定期肺结核并发食管下段癌患者（A组），以及同期310例单纯食管下段癌患者（B组），均行常规食管下段癌手术治疗。回顾性分析在手术时间、出血量、切除率、术后低氧血症、延迟发热、心律失常、肺部并发症、切口不愈、吻合口瘘、手术死亡率、生存率等在2组患者间的差异。采用DPS10．0软件进行统计学分析，计量资料以“x^-±s”表示，采用t检验；计数资料为小样本数据，采用校正y。检验。均以P〈0．05为差异有统计学意义。结果A组患者的手术时间[（3．4±0．4）hl、出血量[（181．0±71．4）ml]、手术根治性切除率（94．1％，32／34）与B组[分别为（3．1±0．4）h、（165．0±80．5）ml、93．5％（290／310）]比较，差异无统计学意义（t=1．77，P=0．055；t=0．73，P=0．241；x^2=0．06，P=0．810）。A组患者术后低氧血症（17．6％，6／34）、手术延迟发热（32．4％，11／34）、肺部并发症（23．5％，8／34）的发生率明显高于B组（分别为6．5％，20／310；16．1％，50／310；10．3％，32／310）（x^2=4．01，P=0．045；x^2=4．47，P=0．034；x^2=3．99，P=0．045）；但心律失常（8．8％，3／34）、切口不愈（2．9％，1／34）、吻合口瘘（5．9％，2／34）、手术死亡率（2．9％，1／34）的发生率与B组（分别为6．1％，19／310；2．9％，9／310；3．9％，12／310；1．0％，3／310）比较，差异无统计学意义（x^2=0．06，P=0．810；x^2=0．28，P=0．599；x^2=0．01，P=0．915；x^2=0．03，P=0．860）。A组1年生存率（94．1％，32／34）、2年生存率（67．6％，23／34）与B组（分别为93．9％，291／310；74．8％，232／310）比较，差异无统计学意义（x^2=0．10，P=0．748；x^2Objective To investigate the feasibility and safety of surgical treatment for patients who have sta ble pulmonary tuberculosis associated with lower esophageal carcinoma. Methods The clinical data of surgical treatment for 34 cases of stable pulmonary tuberculosis associated with lower esophageal carcinoma （Group A） and 310 cases of lower esophageal carcinoma alone （Group B） from March 2009 to March 2014 in Taian Tumor （Tuberculosis） Hospital was collected. All the patients received routine surgical treatment for lower esophageal carcinoma. The difference between both groups in operation lasting time, blood loss, resection rate, postoperative hypoxemia, delayed fever, cardiac arrhythmia, pulmonary complications, wound healing, anastomotic leakage, operative mortality and survival rate was retrospectively analyzed. DPS 10.0 was used for statistical analysis. The measurement data was expressed as ＂x^-±s＂, and t test was used. The count data was small sample data, and the corrected x^2 test was used. P〈0.05 was regarded as statistically significant. Results There was no statistically difference （P〉0. 05） between the two groups in operation lasting time （A： （3.4±0. 4） h, B： （3.1±0.4） h. t= 1.77, P=0. 055）, intraoperative blood loss （A： （181.0±71.4） ml, B： （165.0±80.5） ml. t=0.73, P=0. 241） and the resection rate （A： 94.1% （32/34）, B：93.5% （290/310）. x^2=0.06, P=0. 810）. The incidence rate of postoperative hypoxemia （17.6%, 6/34）, surgical delayed fever （32.4%, 11/34） and pulmonary complications （23.5%, 8/34） in Group A was significantly higher than that in Group B （6.5%, 20/310; 16.1%, 50/310; 0.3%, 32/310） （x^2=4.01, P=0.045; x^2=4.47, P=0.034; x^2=3.99, P=0.045）; but there was no statisti-cally difference （P=0. 05） between the two groups in the incidence rate of cardiac arrhythmia （A： 8. 8% （3/34）, B= 6.1%0 （19/310）;x^2=0.06, P=0.810）, difficult healing wound （A： 2.9% （1/34）, B： 2.9% （9/310

关 键 词：食管肿瘤 结核 肺 消化系统外科手术 对比研究 治疗结果 

分 类 号：R735.1[医药卫生—肿瘤]