经腹与经胸贲门癌根治术治疗高龄早期贲门癌患者的效果及对创伤应激反应的影响  

Effect of transabdominal and transthoracic radical resection of cardiac cancer in the treatment of elderly patients with early cardiac cancer and its influence on traumatic stress response

作　　者：加雄 刘佳 季刚 朱文龙 JIA Xiong;LIU Jia;JI Gang;ZHU Wenlong(Yangling Demonstration Zone Hospital,Xianyang 712100;Shaanxi Provincial Cancer Hospital,Xi'an 710061;the First Affiliated Hospitial of Air Force Military Medical University,Xi'an 710032,China)

机构地区：[1]杨凌示范区医院,陕西咸阳712100 [2]陕西省肿瘤医院,陕西西安710061 [3]空军军医大学第一附属医院,陕西西安710032

出　　处：《临床医学研究与实践》2022年第26期89-93,共5页Clinical Research and Practice

摘　　要：目的 探讨经腹与经胸贲门癌根治术治疗高龄早期贲门癌的效果及对创伤应激反应的影响。方法 纳入2019年1月至2021年11月本院接收的60例高龄早期贲门癌患者作为研究对象,根据治疗方案将其分为观察组和对照组,各30例。观察组采用经腹贲门癌根治术治疗,对照组采用经胸贲门癌根治术治疗。比较两组的治疗效果。结果 两组的手术时间、术中出血量、切缘癌组织阳性率、手术根治率比较,差异无统计学意义(P>0.05);观察组的淋巴清扫数目多于对照组,差异具有统计学意义(P<0.05)。两组的消化道并发症总发生率比较,差异无统计学意义(P>0.05);观察组的心肺并发症总发生率低于对照组,差异具有统计学意义(P<0.05)。术后3 d,两组的C-反应蛋白(CRP)、皮质醇(Cor)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平均高于术前,但观察组低于对照组,差异具有统计学意义(P<0.05)。术后3 d,两组的白细胞分化抗原3阳性(CD3~+)、白细胞分化抗原4阳性(CD4~+)及白细胞分化抗原4阳性/白细胞分化抗原8阳性(CD4~+/CD8~+)均低于术前,但观察组高于对照组,差异具有统计学意义(P<0.05)。术后7 d,两组的癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原199(CA199)、糖类抗原50(CA50)水平均低于术前,且观察组低于对照组,差异具有统计学意义(P<0.05)。结论 经腹或经胸贲门癌根治术治疗高龄早期贲门癌患者均具有一定的效果,可有效清除癌组织,降低肿瘤标志物水平,但经腹贲门癌根治术对患者的创伤应激反应及免疫功能影响更小,肺部并发症也更少,更适用于免疫功能衰退高龄患者的治疗,值得临床推广和应用。Objective To explore the effect of transabdominal and transthoracic radical resection of cardiac cancer in the treatment of elderly patients with early cardiac cancer and its influence on traumatic stress response.Methods A total of 60 elderly patients with early cardiac cancer admitted in our hospital from January 2019 to November 2021 were included as the research objects,and the patients were divided into observation group and control group according to the treatment plan,with 30 cases in each group.The observation group was treated with transabdominal radical resection of cardiac cancer,and the control group was treated with transthoracic radical resection of cardiac cancer.The treatment effects of the two groups were compared.Results There were no significant differences in operation time,intraoperative blood loss,positive rate of resection margin cancer tissue and radical resection rate between the two groups(P>0.05);the number of lymph dissection in the observation group was more than that in the control group,and the difference was statistically significant(P0.05);the total incidence of cardiopulmonary complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).On postoperative 3 d,the levels of C-reaction protein(CRP),cortisol(Cor),interleukin-6(IL-6) and interleukin-8(IL-8) in the two groups were higher than those before operation,but those in the observation group were lower than the control group,and the differences were statistically significant(P<0.05).On postoperative 3 d,cluster of differentiation 3 positive(CD3^(+)),cluster of differentiation 4positive(CD4^(+)) and cluster of differentiation 4 positive/cluster of differentiation 8 positive(CD4^(+)/CD8^(+)) in the two groups were lower than those before operation,but those in the observation group were higher than the control group,and the differences were statistically significant(P <0.05).On postoperative 7 d,the levels of carcinoembryonic antigen(CEA),carbohydrate anti

关 键 词：经腹贲门癌根治术 经胸贲门癌根治术 贲门癌 创伤应激反应 

分 类 号：R735.1[医药卫生—肿瘤]