管状胃-食管吻合术联合胸腔镜食管癌切除术治疗食管癌的效果及对胃肠功能的影响分析  

Analysis of the Effects of Tubular Gastrectomy-Esophageal Anastomosis Combined with Thoracoscopic Esophageal Cancer Resection on Esophageal Cancer and Its Impact on Gastrointestinal Function

作　　者：张光耀 王跃斌[1,2] 方泽民 ZHANG Guangyao;WANG Yuebin;FANG Zemin(Department of Thoracic Surgery,The First Affiliated Hospital of Zhengzhou University,Zhengzhou Henan 450000,China;Henan Provincial Center for Molecular Pathology and Clinical Experimental Research on Chest Diseases,Zhengzhou Henan 450000,China)

机构地区：[1]郑州大学第一附属医院胸外科,河南郑州450000 [2]河南省胸部疾病分子病理与临床实验工程研究中心,河南郑州450000

出　　处：《临床研究》2025年第4期40-43,共4页Clinical Research

摘　　要：目的观察管状胃-食管吻合术联合胸腔镜食管癌切除治疗食管癌的疗效及其对患者胃肠功能的影响,为临床提供参考。方法回顾性分析2022年6月至2024年6月郑州大学第一附属医院收治的82例食管癌患者的临床资料,所有患者均接受胸腔镜食管癌切除术治疗,根据消化道重建方法的不同分为对照组(传统胃-食管吻合术)与研究组(管状胃-食管吻合术),各41例。比较两组患者围术期指标、胃肠功能指标、胃食管反流病问卷(GerdQ)评分、肺功能指标及并发症发生情况。结果研究组患者手术时长与术后胸腔引流时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。两组患者术后24 h胃蠕动频率升高,食管静息压与收缩压降低,且研究组改善更优,差异有统计学意义(P<0.05)。术后1周,两组患者GerdQ评分降低,且研究组更低,差异有统计学意义(P<0.05)。术后1个月,两组患者第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、呼气峰值流速(PEF)水平降低,但研究组高于对照组,差异有统计学意义(P<0.05)。研究组患者并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论在胸腔镜食管癌切除术中应用管状胃-食管吻合术进行消化道重建,有利于改善患者的手术指标,促进术后恢复,调节术后胃肠功能,抑制术后胃食管反流,减少肺功能损伤,同时降低术后并发症发生率。Objective To observe the efficacy of tubular gastrectomy-esophageal anastomosis combined with thoracoscopic esophageal cancer resection in the treatment of esophageal cancer and its impact on gastrointestinal function,providing a reference for clinical practice.Methods A retrospective analysis was conducted on the clinical data of 82 patients with esophageal cancer treated at The First Affiliated Hospital of Zhengzhou University from June 2022 to June 2024.All patients underwent thoracoscopic esophageal cancer resection and were divided into a control group(traditional gastric-esophageal anastomosis)and a study group(tubular gastrectomy-esophageal anastomosis)based on the method of gastrointestinal reconstruction,with 41 cases in each group.The perioperative indicators,gastrointestinal function indicators,Gastroesophageal Reflux Disease Questionnaire(GerdQ)scores,pulmonary function indicators,and incidence of complications were compared between the two groups.Results The duration of surgery and postoperative chest drainage time were shorter in the study group than in the control group,and intraoperative blood loss was less in the study group,with statistically significant differences(P<0.05).24 hours after surgery,both groups showed increased gastric motility frequency and decreased resting and contraction esophageal pressures,with the study group showing better improvement,demonstrating statistical significance(P<0.05).One week postoperatively,GerdQ scores decreased in both groups,with the study group showing lower scores,which was statistically significant(P<0.05).One month after surgery,the forced expiratory volume in 1 second(FEV_(1)),forced vital capacity(FVC),and peak expiratory flow(PEF)levels decreased in both groups,but the study group was higher than the control group,displaying statistical significance(P<0.05).The overall incidence of complications in the study group was lower than that in the control group,with statistically significant differences(P<0.05).Conclusion The application of tubular gastrec

关 键 词：食管癌 胸腔镜食管癌切除术 管状胃-食管吻合术 胃肠功能 

分 类 号：R735.1[医药卫生—肿瘤]