胸腹腔镜Ivor-Lewis手术对食管中下段癌患者肺功能与免疫功能的影响  

Influence of Thoracoscopic Ivor-Lewis Operation on Patients with Middle and Lower Esophageal Cancer on Lung Function and immune function

作　　者：乐静鸿 LE Jinghong(Department of Thoracic Surgery,Guangrao County People's Hospital,Dongying 257300,China)

机构地区：[1]广饶县人民医院胸外科,山东东营257300

出　　处：《中国医药指南》2021年第12期4-6,共3页Guide of China Medicine

摘　　要：目的探讨胸腹腔镜Ivor-Lewis手术对食管中下段癌患者肺功能和免疫功能的影响。方法选取我院2018年6月至2020年5月收治的94例食管中下段癌患者作为研究对象,所有患者均经胃镜确诊为食管癌且为食管中下段癌,肿瘤未发现明显转移。两组术前、围手术期的准备工作和注意事项均相同。对照组行常规开放式Ivor-Lewis手术,研究组行胸腹腔镜Ivor-Lewis手术。比较两组患者术前及术后30 d的肺功能指标,包括用力肺活量占预计值百分比(FVC%)、肺活量占预计值百分比(VC%)、每分钟最大通气量占预计值百分比(MVV%)、第1秒用力呼气量占预计值百分比(FEV_(1)%)。比较两组患者术前及术后30 d免疫功能指标及术后不良反应。结果术前,两组FVC、VC、MVV、FEV_(1)指标比较,差异无统计学意义(P>0.05);术后30 d,两组患者的FVC、VC、MVV、FEV_(1)指标均较术前显著下降,且研究组显著高于对照组(t=4.0832、2.9761、2.9626、2.9685,P<0.05)。术前,两组CD_(8)^(+)、CD_(4)^(+)、CD_(3)^(+)、CD_(4)^(+)/CD_(8)^(+)指标比较,差异无统计学意义(P>0.05);术后30 d,两组CD_(8)^(+)指标均高于术前,且研究组低于对照组(P<0.05);术后两组CD_(4)^(+)、CD_(3)^(+)均低于术前,且研究组高于对照组(P<0.05);而CD_(4)^(+)/CD_(8)^(+)比值变化不大,差异无统计学意义(P>0.05)。研究组术后不良反应发生率显著低于对照组(P<0.05)。结论胸腹腔镜Ivor-Lewis手术治疗食管中下段癌具有较高的安全性和可靠性,能有效改善患者的肺功能、免疫功能,降低术后不良反应发生率。Objective To investigate the effect of thoracoscopic Ivor-Lewis operation on the middle and lower esophagus cancer and its influence on the lung function and immune function of patients.Methods In this study,94 patients with middle and lower esophageal cancer admitted in our hospital from June 2018 to May 2020 were selected as the research objects.All patients were diagnosed as esophageal cancer and middle and lower esophageal cancer by gastroscopy.No significant tumor was found Transfer.The preoperative and perioperative preparations and precautions of the two groups were the same.The control group underwent conventional open trial Ivor-Lewis operation.The study group underwent thoracoscopic Ivor-Lewis operation.Pulmonary function indexes of the two groups were compared before and after 30 days operation,including forced vital capacity as a percentage of predicted value(FVC%),vital capacity as a percentage of predicted value(VC%),maximum ventilation per minute as a percentage of predicted value(MVV%),first Forced expiratory volume per second as a percentage of predicted value(FEV_(1)%).The immune function indexes and postoperative adverse reactions were compared between the two groups of patients before and after 30 days surgery.Results The comparison of the preoperative lung function indexes between the two groups was no significance(P>0.05);after 30 days of operation,the FVC,VC,MVV and FEV_(1) of the two groups of patients decreased significantly,and the study group was significantly higher than the control group(t=4.0832,2.9761,2.9626,2.9685,P<0.05).Before operation,there was no significant difference between the two groups of CD_(8)^(+),CD_(4)^(+),CD_(3)^(+),CD_(4)^(+)/CD_(8)^(+) indicators(P>0.05);after 30 days operation,the CD_(8)^(+)indicators of the two groups were higher than those before operation,and the study group was lower than the control group(P<0.05);CD_(4)^(+) and CD_(3)^(+) in the two groups were lower than before operation,and the study group was higher than the control group(P<0.05);while th

关 键 词：食管中下段癌 胸腹腔镜 IVOR-LEWIS手术 肺功能 免疫功能 

分 类 号：R735.1[医药卫生—肿瘤]