胸腹腔镜Ivor-Lewis手术治疗食管中下段癌的疗效及对患者肺功能和免疫功能的影响  

Therapeutic effect of thoracoscopic and laparoscopic Ivor-Lewis surgery for middle and lower esophageal cancer and its influence on pulmonary function and immune function of patients

作　　者：郭孟刚[1] 杨绪全 周海宁[1] 朱允和[1] GUO Menggang;YANG Xuquan;ZHOU Haining;ZHU Yunhe(Department of Thoracic Surgery,the Central Hospital of Suining,Sichuan Suining 629000,China)

机构地区：[1]遂宁市中心医院胸外科,四川遂宁629000

出　　处：《现代肿瘤医学》2020年第23期4083-4087,共5页Journal of Modern Oncology

基　　金：四川省医学会科研课题计划(编号:S15078)。

摘　　要：目的:探讨胸腹腔镜Ivor-Lewis手术治疗食管中下段癌的疗效,并分析对患者肺功能及免疫功能的影响。方法:选取我院收治的食管中下段癌患者82例,根据手术方式不同分为观察组(n=42)和对照组(n=40)。观察组行胸腹腔镜Ivor-Lewis食管癌切除术,对照组行传统开放Ivor-Lewis食管癌切除术。观察两组患者围手术期指标及术后并发症,分别于术前、术后1月检测患者的肺功能,于术前1天、术后7天检测患者的免疫功能。结果:观察组与对照组的手术时间无统计学差异(P>0.05)。观察组术中出血、留置胸引管时间、住院时间少于对照组,差异有统计学意义(P<0.05)。观察组与对照组喉返神经损伤、吻合口瘘发生率无统计学差异(P>0.05),观察组肺部感染、心律失常低于对照组,差异有统计学意义(P<0.05)。观察组术后1月肺功能各项指标均高于对照组,差异有统计学意义(P<0.05)。观察组术后CD3+、CD4+、CD4+/CD8+均高于对照组,CD8+低于对照组,差异有统计学意义(P<0.05)。结论:胸腹腔镜Ivor-Lewis手术治疗食管中下段癌能减少手术创伤,降低术后并发症,减轻对患者肺功能、免疫功能的影响,有利于患者快速康复,值得临床推广应用。Objective:To investigate the therapeutic effect of thoracoscopic and laparoscopic Ivor-Lewis surgery for middle and lower esophageal cancer,and analyze the influence on pulmonary function and immune function of patients.Methods:82 patients with middle and lower esophageal cancer admitted to our hospital were selected and divided into observation group(n=42)and control group(n=40)according to different surgical methods.The observation group received thoracoscopic and laparoscopic Ivor-Lewis esophagectomy,while the control group received traditional open Ivor-Lewis esophagectomy.The perioperative indexes and postoperative complications of the two groups of patients were observed.The pulmonary function of the patients was detected before operation and 1 month after operation respectively,and the immune function of the patients was detected 1 day before operation and 7 days after operation.Results:There was no statistical difference in the operation time between the observation group and the control group(P>0.05).The observation group had less intraoperative bleeding,indwelling thoracic catheterization time and hospitalization time than the control group(P<0.05).There was no significant difference in the incidence of recurrent laryngeal nerve injury and anastomotic leakage between the observation group and the control group(P>0.05).The incidence of pulmonary infection and arrhythmia in the observation group was lower than that in the control group(P<0.05).The pulmonary function indexes in the observation group were higher than those in the control group 1 month after operation(P<0.05).CD3^+,CD4^+,CD4^+/CD8^+in the observation group were higher than those in the control group,and CD8^+was lower than that in the control group after operation(P<0.05).Conclusion:Thoracoscopic and laparoscopic Ivor-Lewis surgery for middle and lower esophageal cancer can reduce surgical trauma,reduce postoperative complications,reduce the influence on pulmonary function and immune function of patients,and is conducive to rapid recovery of

关 键 词：食管癌 IVOR-LEWIS手术 胸腔镜 腹腔镜 肺功能 免疫功能 

分 类 号：R735.1[医药卫生—肿瘤]