经食管床路径全胸腔镜食管癌手术对食管癌患者胃肠功能、应激反应的影响  

Effect of total thoracoscopic esophageal cancer surgery via the esophageal bed pathway on gastrointestinal function and stress response in patients with esophageal cancer

作　　者：殷优宏[1] 戎国祥[1] 张帆 YIN Youhong;RONG Guoxiang;ZHANG Fan(Department of Cardiothoracic Surgery,the People’s Hospital of Danyang,Danyang 212300,Jiangsu,China)

机构地区：[1]丹阳市人民医院胸心外科,江苏丹阳2123000

出　　处：《癌症进展》2023年第20期2252-2255,共4页Oncology Progress

基　　金：镇江市科技计划项目(SH2021082)。

摘　　要：目的探讨经食管床路径全胸腔镜食管癌手术对食管癌患者胃肠功能、应激反应的影响。方法将86例食管癌手术患者依据手术路径的不同分为对照组38例和研究组48例。对照组患者行常规开胸手术,研究组患者行经食管床路径全胸腔镜食管癌手术。对比两组患者术后胃肠功能指标、应激反应指标、并发症发生情况以及生活质量。结果研究组患者第一次下床时间、第一次排气时间、第一次排便时间、第一次进流食时间及住院时间分别为(24.50±3.55)h、(7.96±1.03)d、(3.73±0.68)d、(5.05±0.64)d、(12.82±0.86)d,分别明显短于对照组患者的(26.18±3.77)h、(8.59±1.15)d、(4.16±0.81)d、(6.14±0.72)d、(15.59±0.69)d,差异均有统计学意义(P﹤0.05)。术后3天,两组患者降钙素原(PCT)和C反应蛋白(CRP)水平均升高,但研究组患者PCT、CRP水平均低于对照组(P﹤0.05)。研究组患者并发症总发生率低于对照组患者(P﹤0.05)。术后,两组患者健康调查简表(SF-36)各维度评分均升高,且研究组患者SF-36各维度评分均高于对照组(P﹤0.05)。结论经食管床路径行全胸腔镜食管癌手术能够促进患者术后胃肠功能恢复,改善患者生活质量,降低术后应激反应和并发症发生率。Objective To investigate the effect of total thoracoscopic esophageal cancer surgery via the esophageal bed pathway on gastrointestinal function and stress response in patients with esophageal cancer.Method A total of 86 patients undergoing esophageal cancer surgery were divided into control group of 38 cases and study group of 48 cases based on different surgical paths.Patients in the control group underwent conventional thoracotomy surgery,while patients in the study group underwent total thoracoscopic esophageal cancer surgery via the esophageal bed pathway.The postoperative gastrointestinal function indicators,stress response indicators,complications,and quality of life of the two groups were compared.Result The first time to get out of bed,the first time to exhaust gas,the first time to defecate,the first time to take liquid food,and the hospital stay of the patients in the study group were(24.50±3.55)h,(7.96±1.03)d,(3.73±0.68)d,(5.05±0.64)d,(12.82±0.86)d,shorter than(26.18±3.77)h,(8.59±1.15)d,(4.16±0.81)d,(6.14±0.72)d,(15.59±0.69)d of the control group,and the differences were statistically significant(P<0.05).Three days after the surgery,the levels of procalcitonin(PCT)and C-reactive protein(CRP)in both groups were increased,while the levels of the two indicators in the study group were lower than those in the control group(P<0.05).The total incidence of complications in the study group was lower than that in the control group(P<0.05).After the surgery,each dimension scores of the MOS 36-item short form health survey(SF-36)of the two groups were increased,and the scores of the study group were higher than those of the control group(P<0.05).Comclusion Total thoracoscopic esophageal cancer surgery via the esophageal bed pathway could promote the recovery of postoperative gastrointestinal function,improve the patients’quality of life,and reduce postoperative stress response and the incidence of complications.

关 键 词：全胸腔镜食管癌手术 经食管床路径 胃肠功能 应激反应 并发症 

分 类 号：R735.1[医药卫生—肿瘤]