胸腹腔镜Ivor-Lewis手术对中下段食管癌患者术后炎症损伤及疼痛刺激的影响  

Effects of thoracic laparoscopic Ivor-Lewis surgery on postoperative inflammatory damage and pain stimulation in patients with middle and lower esophageal cancer

作　　者：王宇麟 徐晓战 奚建立 Wang Yulin;Xu Xiaozhan;Xi Jianli(Department of Cardiothoracic Surgery,Xuchang People's Hospital,Xuchang,Henan 461000,China)

机构地区：[1]许昌市人民医院心胸外科,河南许昌461000

出　　处：《现代临床医学》2024年第3期194-197,共4页Journal of Modern Clinical Medicine

摘　　要：目的:探究胸腹腔镜Ivor-Lewis手术治疗中下段食管癌(EC)患者的效果及对炎症损伤和疼痛刺激的影响。方法:回顾性分析2020年1月至2023年2月我院92例中下段EC患者的病例资料,按手术方案不同分为A组和B组。A组采用胸腹腔镜Ivor-Lewis手术治疗,B组采用开放Ivor-Lewis手术治疗。比较两组手术指标、手术前后肺功能指标、炎症因子水平及并发症发生率。结果:A组住院时间短于B组,术中失血量少于B组(P<0.05)。术后3 d A组第1秒用力呼气量占用力肺活量百分比高于B组,血清5-羟色胺、神经肽Y、P物质、白细胞介素-6水平低于B组,血清白细胞介素-2、γ-干扰素水平高于B组(P<0.05)。A组并发症发生率低于B组(P<0.05)。结论:中下段EC患者经胸腹腔镜Ivor-Lewis手术治疗效果更好,不仅能有效减少术中失血量,避免过度疼痛刺激及炎症损伤,还能降低并发症发生风险,对患者肺功能影响更小,有助于缩短康复进程。Objective:To investigate the efficacy of thoracic laparoscopic Ivor-Lewis surgery in the treatment of patients with middle and lower esophageal cancer(EC)and its impact on inflammatory damage and pain stimulation.Methods:A retrospective analysis was conducted on the case data of 92 patients with middle and lower EC in our hospital from January 2020 to February 2023.They were divided into group A and group B according to different surgical plans.Group A underwent thoracic laparoscopic Ivor-Lewis surgery,while group B underwent open Ivor-Lewis surgery.Surgical indicators,preoperative and postoperative lung function indicators,levels of inflammatory factors,and incidence of complications were compared between the two groups.Results:The hospitalization time of group A was shorter than that of group B,and the intraoperative blood loss was less than that of group B(P<0.05).Three days after surgery,group A showed higher FEV_(1)/FVC than group B,lower serum levels of 5-HT,neuropeptide Y,substance P,and IL-6 than group B,higher serum levels of IL-2 and IFN-γ than group B(P<0.05).Moreover,group A had lower incidence of complications than group B(P<0.05).Conclusion:Thoracic laparoscopic Ivor-Lewis surgery is more effective in the treatment of patients with middle and lower EC.It can not only effectively reduce intraoperative blood loss,avoid excessive pain stimulation and inflammatory damage,but also reduce the risk of complications.It has a smaller impact on the patient's lung function and helps to shorten the recovery process.

关 键 词：食管癌 胸腹腔镜 肺功能 炎症因子 疼痛程度 

分 类 号：R735.1[医药卫生—肿瘤]