改良全腔镜术对伴慢性肺部疾病食管癌病人肺功能、术后进食、并发症的影响  

The effect of improved total cavity endoscopy on lung function,postoperative feeding and complications in patients with chronic lung disease of esophageal cancer

作　　者：王继超 薛军英 张建华 杨锦 王林佩 WANG Jichao;XUE Junying;ZHANG Jianhua;YANG Jin;WANG Linpei(Department of Cardiothoracic Surgery,The Second People’s Hospital of Hengshui,Hengshui 053000,China;不详)

机构地区：[1]河北省衡水市第二人民医院心胸外科,053000 [2]河北衡水市第三人民医院肺病科

出　　处：《临床外科杂志》2024年第8期807-810,共4页Journal of Clinical Surgery

基　　金：衡水市重点研发计划(2020014033Z)。

摘　　要：目的探讨改良全腔镜术对伴慢性肺部疾病食管癌病人肺功能、术后进食、并发症的影响。方法2022年9月~2023年6月收治的伴慢性肺部疾病食管癌病人120例,采用随机数字表法分为两组。观察组60例,行改良全腔镜辅助食管癌切除术,对照组60例,行传统开放手术。比较两组病人围术期相关指标以及术前、术后1周、2周的肺功能指标[第1秒用力呼气容积(FEV 1)、用力肺活量(FVC)、最大通气量(MVV)]、炎症因子水平[白细胞介素(IL)-6、IL-8、肿瘤坏死因子(TNF)-α]、术后进食、并发症发生情况。结果观察组术中出血量、手术时间、淋巴结清扫数量、引流时间分别为(329.51±78.84)ml、(175.47±10.41)分钟、(29.67±17.86)枚/例、(3.14±0.98)天;对照组分别为(372.31±99.23)ml、(148.54±10.68)分钟、(28.36±18.15)枚、(6.37±1.23)天,两组比较差异有统计学意义(P<0.05);观察组术后2周的FEV 1、FVC、MVV分别为(1.88±0.53)L、(2.33±0.46)L、(32.59±11.84)L;对照组分别为(1.37±0.31)L、(1.75±0.38)L、(23.68±9.41)L,两组比较差异有统计学意义(P<0.05);观察组术后2周的炎症因子IL-6、IL-8、TNF-α分别为(2.17±1.62)ng/ml、(2.09±1.52)ng/ml、(1.32±0.57)ng/ml;对照组分别为(3.06±1.52)ng/ml、(2.75±1.29)ng/ml、(1.73±0.75)ng/ml,两组比较差异有统计学意义(P<0.05);观察组与对照组的术后并发症发生率分别为6.67%、20.00%,观察组病人术后进食早于对照组,两组比较差异有统计学意义(P<0.05)。结论改良全腔镜手术相较于传统开放手术,手术创伤小、操作简便,对肺功能损伤较小,术后并发症发生率低,术后进食早。Objective To explore the effect of improved total cavity endoscopy on lung function,postoperative feeding and complications in patients with chronic lung disease of esophageal cancer.Methods 120 esophageal cancer patients with chronic lung disease admitted to our hospital from September 2022 to June 2023 were randomly divided into two groups.The observation group consisted of 60 patients who underwent improved total cavity endoscopy assisted esophageal cancer resection,while the control group consisted of 60 patients who underwent traditional open surgery.The perioperative related indexes,lung function indexes[forced expiratory volume in the first second(FEV 1),forced vital capacity(FVC),maximum ventilation volume(MVV)],inflammatory level[interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor(TNF-α)]were compared between the two groups.Results The blood loss,operation time,number of lymph node dissection and drainage time in the observation group were(329.51±78.84)ml,(175.47±10.41)min,(29.67±17.86)pieces per case and(3.14±0.98)d respectively.In the control group,the intraoperative blood loss,operation time,number of lymph node dissection and drainage time were(372.31±99.23)ml,(148.54±10.68)min,(28.36±18.15)pieces and(6.37±1.23)d,respectively,there was statistical significance between the two groups(P<0.05).The FEV 1,FVC and MVV of the observation group were(1.88±0.53)L,(2.33±0.46)L and(32.59±11.84)L,respectively.Two weeks after operation,the control group was(1.37±0.31)L,(1.75±0.38)L and(23.68±9.41)L respectively,there was statistical significance between the two groups(P<0.05).The inflammatory factors IL-6,IL-8 and TNF-αin the observation group were(2.17±1.62)ng/ml,(2.09±1.52)ng/ml and(1.32±0.57)ng/ml,respectively.The control group were(3.06±1.52)ng/ml,(2.75±1.29)ng/ml and(1.73±0.75)ng/ml respectively,there was statistical significance between the two groups(P<0.05).The incidence of postoperative complications in the observation group and the control group were 6.67%and 20.00%respect

关 键 词：食管癌 改良全腔镜术 传统开放手术 肺功能 并发症 

分 类 号：R735.1[医药卫生—肿瘤]