胸腹腔镜McKeown根治术治疗老年食管癌的效果及对免疫功能、围手术期炎症反应的影响  

Effect of Thoracic Laparoscopic McKeown Radical Operation on Elderly Patients with Esophageal Cancer and Its Effect on Immune Function and Perioperative Inflammatory Response

作　　者：靳争义[1] 宋应明[1] 南毅[1] 张王军 JIN Zhengyi;SONG Yingming;NAN Yi;ZHANG Wangjun(Heping Hospital Affiliated to Changzhi Medical College,Changzhi 046000,China;不详)

机构地区：[1]长治医学院附属和平医院,山西长治046000

出　　处：《中国医学创新》2023年第21期14-18,共5页Medical Innovation of China

摘　　要：目的:探讨胸腹腔镜McKeown根治术治疗老年食管癌的效果及对免疫功能、围手术期炎症反应的影响。方法:选取2021年1月—2023年1月长治医学院附属和平医院收治的老年食管癌患者84例,根据治疗术式不同分为两组。对照组(42例)采用传统开胸食管癌根治术治疗,观察组(42例)采用胸腹腔镜McKeown根治术治疗,比较两组围手术期指标、免疫功能指标[免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)]、炎症反应指标[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]及并发症发生情况。结果:观察组术中出血量少于对照组,胸腔引流时间、住院时间均短于对照组(P<0.05);两组手术时间、淋巴结清扫数目差异均无统计学意义(P>0.05)。术后3 d,观察组免疫功能指标IgA、IgM、IgG水平均高于对照组(P<0.05)。术后3 d,观察组CRP、TNF-α、IL-6水平均低于对照组(P<0.05)。观察组并发症发生率(9.52%)低于对照组(26.19%),差异有统计学意义(P<0.05)。结论:胸腹腔镜McKeown根治术治疗老年食管癌具有创伤小、并发症少、术后恢复快等优势,且对患者免疫功能和炎症反应影响小,可作为临床治疗老年食管癌的有效术式。Objective:To investigate the effect of thoracic laparoscopic McKeown radical operation on elderly patients with esophageal cancer and its influence on immune function and perioperative inflammatory response.Method:Eighty-four elderly patients with esophageal cancer admitted to Heping Hospital Affiliated to Changzhi Medical College from January 2021 to January 2023 were selected and divided into two groups according to different treatment methods.The control group(42 cases)was treated with traditional thoracotomy radical resection of esophageal cancer,and the observation group(42 cases)was treated with thoracic laparoscopic McKeown radical resection.Perioperative indexes,immune function indexes[immunoglobulin A(IgA),immunoglobulin M(IgM),immunoglobulin G(IgG)],inflammatory response indicators[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C reactive protein(CRP)]and the incidence of complications of the two groups were compared.Result:The intraoperative blood loss in the observation group was less than that in the control group,the time of thoracic drainage and hospital stay were shorter than those in the control group(P<0.05).The operation time and the number of lymph nodes dissection in the two groups were no significant differences(P>0.05).The levels of IgA,IgM and IgG in the observation group were higher than those in the control group 3 days after surgery(P<0.05).The levels of CRP,TNF-αand IL-6 in the observation group were lower than those in the control group 3 days after surgery(P<0.05).The complication rate of the observation group(9.52%)was lower than that of the control group(26.19%)(P<0.05).Conclusion:Thoracic laparoscopic McKeown radical operation in the treatment of elderly esophageal cancer has the advantages of less trauma,fewer complications,quick postoperative recovery,and little effect on the immune function and inflammatory response of patients,and can be used as an effective surgical treatment for elderly esophageal cancer.

关 键 词：食管癌 胸腹腔镜McKeown根治术 免疫功能 围手术期炎症反应 

分 类 号：R735.1[医药卫生—肿瘤]