探讨胸腹腔镜手术治疗老年食管癌的临床疗效及对预后的影响  

Investigation on the Clinical Efficacy of Thoracic Laparoscopic Surgery for Elderly Patients with Esophageal Cancer and Its Influence on Prognosis

作　　者：邓卫军[1] 陈桂明[1] 顾云[1] 施乃明 DENG Wei-jun;CHEN Gui-ming;GU Yun;SHI Nai-ming(Department of Thoracic Surgery,People's Hospital of Lianshui County,Lianshui,Jiangsu Province,223400 China)

机构地区：[1]涟水县人民医院胸外科

出　　处：《中外医疗》2019年第29期4-6,共3页China & Foreign Medical Treatment

基　　金：淮安市重点研发计划(社会发展)计划：老年性食管癌新型多学科临床综合治疗研究(HAS201622)

摘　　要：目的 探讨胸腹腔镜手术对老年食管癌的治疗效果。方法 该研究方便选取2016年10月-2018年12月期间在该院住院治疗的80例食管癌老年患者为研究对象,根据前瞻性研究手段将80例患者进行分组。对照组实施传统开放手术,观察组实施胸腹腔镜手术。对比两种术式多个手术指标情况,并就治疗前后患者免疫功能变化情况作对比。结果 从疾病控制率上来看[87.50%vs80.00%],两组差异无统计学意义(χ2=0.827,P>0.05)。观察组患者手术时间(155.47±20.42)min、出血量(285.17±40.23)mL、住院时间(10.22±1.47)d均显著低于对照组(189.25±25.14)min、(348.75±45.88)mL、(14.43±1.85)d(t=5.596,6.590,7.060,P<0.05)。治疗前,两组患者免疫功能各项指标比较差异无统计学意义(P>0.05),出院时,观察组患者CD4+(35.88±2.18)、CD8+(27.15±3.14)、CD4+/CD8+(1.48±0.25)与治疗前组内比较有显著改善,差异有统计学意义(t=6.452,11.233,4.083,P<0.05);且与对照组出院时CD4+(32.47±2.10)、CD8+(16.88±3.21)、CD4+/CD8+(1.31±0.29)组间比较差异有统计学意义(t=7.125,14.465,2.808,P<0.05)。结论 胸腹腔镜手术的操作快捷,手术时间短、出血量少,再加上手术对患者的损伤小,患者术后恢复快,有助于预后,值得推广。Objective To explore the therapeutic effect of thoracoscopic laparoscopic surgery on esophageal cancer in the elderly.Methods Convenient select eighty elderly Patients with esophageal cancer who were hospitalized in our hospital from October 2016 to December 1818 were enrolled in the study.Eighty Patients were grouped according to prospective study.The control group underwent traditional open surgery and the observation group underwent thoracoscopic surgery.Compare the surgical outcomes of the two surgical procedures and compare the changes of immune function before and after treatment.Results From the point of view of disease control rate,there was no significant difference between the two groups[87.50%vs 80.00%](χ^2=0.827,P>0.05).The operation time(155.47±20.42)min,blood loss(285.17±40.23)mL,and hospitalization time(10.22±1.47)d were significantly lower in the observation group than in the control group(189.25±25.14)min,(348.75±45.88)mL,(14.43±1.85)d,the difference was statistically significant(t=5.596,6.590,7.060,P<0.05).Before treatment,there was no significant difference in the immune function between the two groups.At the time of discharge,the patients in the observation group were CD4+(35.88±2.18),CD8+(27.15±3.14),CD4+/CD8+(1.48±0.25).There was a significant improvement compared with the pre-treatment group(t=6.45211.233,4.083,P<0.05);and CD4+(32.47±2.10),CD8+(16.88±3.21),CD4 at the time of discharge from the control group of+/CD8+(1.31±0.29),the difference was statistically significant(t=7.125,14.465,2.808,P<0.05).Conclusion The operation of thoracoscopic laparoscopic surgery is quick,the operation time is short,the amount of bleeding is small,and the injury to the patient is small.The patient recovers quickly and helps the prognosis.It is worth promoting.

关 键 词：胸腹腔镜手术 食管癌 免疫功能 预后 

分 类 号：R735.1[医药卫生—肿瘤]