单孔腔镜手术对食管癌患者创伤应激、短期预后的影响  

Effects of single-port endoscopic surgery on traumatic stress and short-term prognosis of patients with esophageal cancer

作　　者：郝延红[1] 张伟 HAO Yan-hong;ZHANG Wei(Department of Thoracic Surgery,Yulin First Hospital,Yulin 718000,China;Department of Digestive Surgery,Xi'an People's Hospital)

机构地区：[1]榆林市第一医院胸外科,陕西榆林718000 [2]西安市人民医院消化外科

出　　处：《腹腔镜外科杂志》2022年第11期819-823,共5页Journal of Laparoscopic Surgery

基　　金：陕西省医学科学研究课题计划面上项目(2019JM0898)。

摘　　要：目的:探讨单孔腔镜手术对食管癌患者创伤应激、短期预后的影响。方法:选取2018年1月至2020年10月收治的126例食管癌患者,采用随机数字表法分为两组,每组63例,对照组行三孔腔镜手术,观察组行单孔腔镜手术。对比两组手术相关指标、并发症、预后及手术前后创伤应激指标、吞咽功能、生活质量。结果:观察组住院时间短于对照组,术后24 h疼痛评分低于对照组,总手术时间长于对照组(P<0.05)。术后第3天,观察组红细胞黏附肿瘤细胞花环率、红细胞C3b受体花环率水平高于对照组,红细胞免疫复合物花环率水平低于对照组(P<0.05)。两组并发症发生率差异无统计学意义(P>0.05)。术后12个月,两组复发率及生存率差异无统计学意义(P>0.05)。术后6个月、12个月,两组吞咽功能评分低于术前,生活质量评分均高于术前(P<0.05)。结论:单孔腔镜手术治疗食管癌利于缓解疼痛,可缩短住院时间,改善吞咽功能,且对创伤应激反应影响较小。Objective:To investigate the effect of single-port endoscopic surgery on traumatic stress and short-term prognosis of patients with esophageal cancer.Methods:A total of 126 patients with esophageal cancer from Jan.2018 to Oct.2020 were selected and randomly divided into two groups,with 63 cases in each group.The control group underwent three-port endoscopic surgery,and the o bservation group underwent single-port endoscopic surgery.The operation-related indicators,complications,prognosis,and trauma stress indicators,swallowing function,quality of life before and after surgery were observed and compared between the two groups.Results:The hospital stay of the observation group was shorter than that of the control group,and the pain score of 24 h after operation was lower than that of the control group,the opeiative time was longer than that of the control group(P<0.05),On the third day after operation,the r osette rate of erythrocyte adhere to tumor cell and the red blood cell C3b receptor rosette rate of the obs ervation group were higher than those of the control group,while the red blood cell immune complex rosette rate level was lower than that of the control group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Twelve months after operation,there was no significant difference in the recurrence rate and survival rate between the two groups(P>0.05).The swallowing function scores of the two groups at 6 months and 12 months after the operation were lower than those before operation,and the quality of life scores were higher than those before operation(P<0.05).Conclusions:Single-port endoscopic surgery for patients with esophageal cancer is beneficial to relieving pain,shortening hospital stay,improving swallowing function,and has little effect on traumatic stress r esponse.

关 键 词：食管肿瘤 腹腔镜检查 单孔法 应激障碍 创伤性 预后 

分 类 号：R735.1[医药卫生—肿瘤]