胸腹腔镜微创手术与传统开胸手术对食管癌患者术后肺部感染及肺功能的影响  

Effects of laparothoracoscopic minimally invasive surgery and traditional thoracotomy on postoperative pulmonary infection and lung function in patients with esophageal cancer

作　　者：张喜平[1] 吕艳 Zhang Xiping, Lyu Yan(1. Department of Cardiothoracic Surgery, the People＇ s Hospital of Tanghe, Tanghe 473400, China ; 2.Department of Surgery, the Traditional Chinese Medicine Hospital of Tanghe, Tanghe 473400, China)

机构地区：[1]河南省唐河县人民医院心胸外科,473400 [2]河南省唐河县中医院外科,473400

出　　处：《中国实用医刊》2018年第1期71-73,共3页Chinese Journal of Practical 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部感染及肺功能的影响。方法选择确诊并需要进行手术治疗的150例食管癌患者作为研究对象，根据手术方式将其分为观察组（胸腹腔镜微创手术）与对照组（传统开胸手术），每组75例。比较两组围术期指标、肺部感染发生率及肺功能指标[用力肺活量（FVC）、1s用力呼气容积（FEV1）、FEV1占预计值的百分比（FEV1％）]变化情况。结果与对照组比较，观察组手术时间更长，淋巴结清扫数量更多，出血量更少，住院时间更短，差异有统计学意义（P〈0．05）。对照组术后肺部感染发生率高于观察组，差异有统计学意义（P〈0．05）。术前两组肺功能指标比较差异未见统计学意义（P〉0．05）；术后两组肺功能指标均降低，对照组降低趋势更明显，差异有统计学意义（P〈0．05）。结论与传统开胸手术比较，胸腹腔镜微创手术治疗食管癌更具优势，术中对患者的创伤较小，能够减少术后肺部感染的发生，降低对肺功能的损害，从而使患者获得较好的预后，值得临床广泛应用。Objective To investigate the effect of laparothoracoscopic minimally invasive surgery and traditional thoracotomy on postoperative pulmonary infection and lung function in patients with esophageal cancer. Methods A total of 150 patients who were diagnosed with esophageal cancer and needed surgery were divided into observation group（laparothoracoscopic minimally invasive surgery） and control group （traditional thoracotomy） by surgical methods, with 75 cases in each group. The perioperative indexes, incidence of pulmonary infection and indexes of lung function [ forced vital capacity （FVC）, forced expiratory volume in one second （FEV1）, percentage of FEV1 on prediced value （FEV1%）] were compared between the two groups. Results Compared with control group, the operation time of observation group was longer, the amount of lymph node dissection was bigger, the bleeding volume was less and the hospital stays were shorter （P 〈0. 05）. The incidence of postoperative pulmonary infection in control group was higher than that in observation group （P 〈 0. 05）. Before surgery, there was no significant difference in the indexes of lung function between the two groups （P 〉 0. 05） ; after surgery, the indexes of lung function in two groups all decreased, and the descend range of control group was more significant （P 〈 0. 05）. Conclusions Compared with traditional thoracotomy, laparothoracoscopic minimally invasive surgery has more advantages and less injury, which can reduce postoperative pulmonary infection and decrease the damage to lung function so as to achieve better prognosis, so it is worthy of clinical application.

关 键 词：微创手术 开胸手术 食管癌 肺部感染 肺功能 

分 类 号：R735.1[医药卫生—肿瘤]