胸腹腔镜食管癌根治术中人工气胸的应用效果分析  

Application effect analysis of artificial pneumothorax in thoracoscopic and laparoscopic radical esophageal cancer surgery

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

机构地区：[1]丹阳市人民医院胸心外科,江苏丹阳212300

出　　处：《腹腔镜外科杂志》2024年第8期579-583,共5页Journal of Laparoscopic Surgery

基　　金：镇江市科技计划项目(SH2021082)。

摘　　要：目的:探讨胸腹腔镜食管癌根治术中人工气胸的应用效果。方法:选取2016年8月至2023年3月行胸腹腔镜食管癌根治术的86例患者,将患者按随机数字表法分为对照组(n=43)与观察组(n=43),对照组行双腔管单肺通气,观察组行单腔管双肺通气联合人工气胸;比较两组手术时间、术中出血量、术后清醒时间、术后住院时间及人工气胸或单肺通气前(T_(1))、人工气胸或单肺通气30 min(T_(2))、人工气胸或单肺通气60 min(T_(3))、术后30 min(T4)的PaCO_(2)、PaO_(2)、平均动脉压及心率。结果:观察组术后住院时间短于对照组(P<0.05);T_(2)、T_(3)时,观察组PaCO_(2)水平高于T_(1)时;观察组高于对照组(P<0.05);T_(2)、T_(3)、T4时,两组PaO_(2)水平均低于T_(1)时,观察组高于对照组(P<0.05);T_(2)时,两组平均动脉压水平均高于T_(1)时,观察组高于对照组(P<0.05);T_(2)、T_(3)时,两组心率均高于T_(1)时,观察组高于对照组(P<0.05)。观察组术后并发症总发生率低于对照组[18.60%(8/43)vs.39.53%(17/43),P=0.033]。结论:胸腹腔镜食管癌根治术中应用人工气胸对术中呼吸、血流动力学均有影响,术后并发症更少,康复更快。Objective:To investigate the application effect of artificial pneumothorax on the thoracoscopic and laparoscopic ra-d ical surgery for esophageal cancer.Methods:A total of 86 patients who were scheduled to undergo thoracoscopic and laparoscopic radical surgery for esophageal cancer from Aug.2016 to Mar.2023 were collected.All patients were randomly assigned to control group(n=43)and observation group(n=43)using random number table method.The control group received dual-lumen tube single lung ventilation,while the observation group received single lumen tube double-lung ventilation combined with artificial pneumothorax.The surgery time,intraoperative blood loss,postoperative wakefulness time,postoperative hospital stay,and PaCO_(2),PaO_(2),mean arterial pressure(MAP),and heart rate before artificial pneumothorax or one-lung ventilation(T_(1)),after 30 min of artificial pneumothorax or one-lung ventilation(T_(2)),after 60 min of artificial pneumothorax or one-lung ventilation(T_(3)),and at 30 min after operation(T_(4))were compared between the two groups.Results:The postoperative hospital stay of the observation group was significantly shorter than that of the control group(P<0.05).In the observation group,PaCO_(2)levels at T_(2)and T_(3)were significantly higher than that at T_(1),the observation group was higher than the control group.PaO_(2)levels at T_(2),T_(3),and T 4 were lower than that at T_(1)in the both groups,the observation group was higher than the control group(P<0.05).MAP level at T_(2)was higher than that at T_(1)in the both groups,the observation group was higher than the control group.Heart rate at T_(2)and T_(3)was higher than that at T_(1)in both groups,the observation group was higher than the control group(P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group[18.60%(8/43)vs.39.53%(17/43),P=0.033].Conclusions:The application of artificial pneumothorax in thoracoscopic and la-p aroscopic radical esophageal cancer surgery has

关 键 词：食管切除术 胸腔镜检查 腹腔镜检查 气胸 人工 疗效比较研究 

分 类 号：R655.4[医药卫生—外科学]