胸腹腔镜联合根治术治疗老年食管癌对患者胃肠道功能和凝血功能的影响  

The Effect of Thoracoscopy Combined with Laparoscopic Total Laparoscopic Radical Surgery in the Treatment of Elderly sophageal Cancer on the Gastrointestinal Function and Coagulation Function of Patients

作　　者：刘锋[1] 王侃[1] 韩玉龙[1] 曹纪伟[1] 朱红军[1] LIU Feng;WANG Kan;HAN Yu-long;CAO Ji-wei;ZHU Hong-jun(Department of Thoracic Surgery,The First People's Hospital of Shangqiu City,Shangqiu 476000 China)

机构地区：[1]河南商丘市第一人民医院胸外科,河南商丘476000

出　　处：《内蒙古医学杂志》2021年第11期1321-1324,共4页Inner Mongolia Medical Journal

基　　金：河南省自然科学基金(编号:LHGJ20170056214)。

摘　　要：目的探讨胸腔镜联合腹腔镜全腔镜根治手术治疗老年食管癌对患者胃肠道功能和凝血功能的影响。方法选取2019年3月至2020年3月在本院确诊的120例老年食管癌患者,根据采取的手术术式的不同,将患者分为观察组57例和对照组63例。对照组患者采用传统食管癌根治术治疗,观察组采用胸腹腔镜联合根治术治疗。分别于治疗前后,采用全自动血凝仪和ELISA分别测定术前和术后24 h凝血指标活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)水平、凝血酶原时间(PT)、D二聚体(D-D)水平,对比患者手术、术后相关指标以及凝血功能相关指标。记录两组治疗期间的并发症的发生情况。结果观察组手术时间、手术出血量以及引流量均明显低于对照组(P<0.05);观察组患者术后相关指标肠鸣音次数、术后通气时间、胃肠功能恢复时间、术后住院时间(d)均显著低于对照组(P<0.05)。术后两组患者APTT、PT水平较治疗前明显降低,且观察组降低程度明显大于对照组(P<0.05);两组患者治疗后FIB、D-D水平则较治疗前明显升高(P<0.05),且观察组升高程度明显大于对照组(P<0.05)。结论胸腹腔镜治疗食管癌的临床疗效确切,能有效促进术后患者胃肠道功能的恢复,但对患者的凝血功能影响较大,容易引起高凝状态,临床应加强术后相关防治。Objective To investigate the effect of thoracoscopy combined with laparoscopic total laparoscop-ic radical surgery in the treatment of elderly esophageal cancer on the gastrointestinal function and coagulation func-tion of patients.Methods A total of 120 elderly patients with esophageal cancer diagnosed in our hospital from March 2019 to March 2020 were selected.The patients were divided into(n=57)and control groups(n=63)ac-cording to the different surgical procedures.Patients in the control group were treated with traditional radical resec-tion of esophageal cancer,and the observation group was treated with thoracolaparoscopic combined radical resec-tion.Before and after treatment,automatic blood coagulometer and ELISA were used to determine the 24h coagula-tion index activated partial thromboplastin time(APTT),fibrinogen(FIB)level,prothrombin time(PT),D Di-mer(DD)level,compare patients'surgery,postoperative related indexes and blood coagulation function related in-dexes.The occurrence of complications during the treatment of the two groups was recorded.Results The opera-tion time,operative blood loss and drainage volume of the observation group were significantly lower than those of the control group(P<0.05);the observation group was related to the number of postoperative bowel sounds,post-operative ventilation time,gastrointestinal function recovery time,and postoperative hospitalization.The time(d)was significantly lower than that of the control group(P<0.05).The levels of APTT and PT in the two groups after treatment were significantly lower than before treatment,and the reduction in the observation group was significantly greater than that in the control group(P<0.05);after treatment,the levels of FIB and DD in the two groups were significantly higher than before treatment(P<0.05)),and the degree of increase in the observation group was significantly greater than that in the control group(P<0.05).Conclusion Thoracic laparoscopic treatment of e-sophageal cancer has a definite clinical effect and can effectiv

关 键 词：腹腔镜 胸腔镜 食管癌根治术 凝血功能 

分 类 号：R656[医药卫生—外科学]