胸腔镜下小切口切除术对食管癌患者术后炎性反应及肺功能的影响
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摘要
目的探讨采用胸腔镜下小切口切除术对食管癌患者术后炎性反应及肺功能的影响。方法选择河南省汝州市人民医院2015年4月至2017年4月收治的食管癌患者96例,将其按盲抽法分为两组,各48例。对照组采用传统开胸手术,观察组采用胸腔镜下小切口切除术,术后随访1个月,比较两组炎性因子水平、肺功能及并发症发生率。结果术后第7 d观察组IL-6、IL-10、TNF-α水平均较对照组低,术后1个月观察组用力肺活量占预计值百分比、第1秒用力呼气量占预计值百分比均较对照组高,并发症发生率较对照组低,差异具有统计学意义(P<0.05)。结论相较于传统开胸手术,胸腔镜下小切口切除术治疗食管癌不仅可减轻机体创伤性,降低术后并发症发生率,且在减轻机体炎症反应、提升肺功能等方面更具优势,利于改善患者预后。
Objective To investigate the effect of thoracoscopic small incision resection on inflammatory response and lung function in patients with esophageal cancer. Methods Ninety-six patients with esophageal cancer admitted to the People's Hospital of Ruzhou City, Henan Province from April 2015 to April 2017 were selected and divided into two groups equally. The patients in the control group were treated by conventional thoracotomy. The patients underwent thoracoscopic small incision resection and were followed up for 1 month. The levels of inflammatory factors, lung function and complication rate were compared between the two groups. Results On the 7 th day after operation, the levels of IL-6, IL-10 and TNF-α in the observation group were lower than those in the control group. After 1 month, the forced vital capacity of the observation group accounted for the percentage of the predicted value. And the forced expiratory volume in the first second accounted for the predicted percentage was higher than that of control group. The incidence of complication was lower than that of control group significantly(P<0.05). Conclusions Compared with traditional thoracotomy, thoracoscopic small incision for esophageal cancer can not only reduce the trauma and the incidence of postoperative complications, but also improve the prognosis by reducing the body's inflammatory response and improving lung function.
Objective To investigate the effect of thoracoscopic small incision resection on inflammatory response and lung function in patients with esophageal cancer. Methods Ninety-six patients with esophageal cancer admitted to the People's Hospital of Ruzhou City, Henan Province from April 2015 to April 2017 were selected and divided into two groups equally. The patients in the control group were treated by conventional thoracotomy. The patients underwent thoracoscopic small incision resection and were followed up for 1 month. The levels of inflammatory factors, lung function and complication rate were compared between the two groups. Results On the 7 th day after operation, the levels of IL-6, IL-10 and TNF-α in the observation group were lower than those in the control group. After 1 month, the forced vital capacity of the observation group accounted for the percentage of the predicted value. And the forced expiratory volume in the first second accounted for the predicted percentage was higher than that of control group. The incidence of complication was lower than that of control group significantly(P<0.05). Conclusions Compared with traditional thoracotomy, thoracoscopic small incision for esophageal cancer can not only reduce the trauma and the incidence of postoperative complications, but also improve the prognosis by reducing the body's inflammatory response and improving lung function.
引文
[1] 刘良,杨立信,徐志云.全胸腔镜食管癌根治术对患者术后肺功能及炎性因子的影响[J].海南医学院学报,2016,22(18):2136-2138,2142.
[2] 施庆彤.胸腔镜手术与开胸手术治疗食管癌疗效比较[J].山东医药,2015,55(42):61-62.
[3] 宋琦.全胸腔镜手术与传统开胸手术治疗食管癌患者近期临床疗效比较[J].医疗装备,2016,29(6):19-20.
[4] 毛系才,汤井双,周杰.胸腔镜与开胸手术对中老年食管癌术后早期康复的影响[J].山西医药杂志,2017,46(5):554-555.
[5] 太祥,鲍亚男,洪志鹏.胸腔镜下食管癌切除术25例临床病例分析[J].昆明医科大学学报,2016,37(3):57-59.
[6] 毛友生,赫捷,章智荣,等.胸段食管癌经胸腔镜手术与常规开胸手术淋巴结清扫程度的比较[J].中华肿瘤杂志,2015,37(7):530-533.
[7] 李雪益,沃西文,童莉,等.食管癌VATS切除术与开胸切除术术后并发症及预后比较[J].西南国防医药,2015,25(5):496-498.
[8] 李凡,李标,王琼育,等.食管癌患者行胸腔镜切除术后对肺部感染和炎症细胞因子的影响[J].中华医院感染学杂志,2017,27(17):3944-3947.
[9] 李志龙,王一心,臧建洲.不同食管癌根治术对患者术后肺功能及炎性因子水平的影响[J].检验医学与临床,2016,13(6):746-748,751.
[10] 张续民,凤雷.胸腔镜切除术与传统式手术对食管癌术后肺部功能和炎症细胞因子的影响[J].实用癌症杂志,2017,32(10):1617-1620.
[11] 杨博,白传明,肖连波.对比微创食管癌切除术与传统食管胃胸内吻合术对食管癌患者肺功能及炎症细胞因子的影响[J].胃肠病学和肝病学杂志,2015,24(6):720-723.
[12] 李刚,杨双强,刘衡,等.胸腔镜食管癌切除术中行广泛纵隔淋巴结清扫的效果及对术后肺功能的影响[J].河北医学,2015,21(12):1937-1940.
[13] 邓海青,杜正隆,凌毅,等.全胸腔镜与辅助小切口胸腔镜肺癌切除术效果比较[J].现代肿瘤医学,2016,24(21):3398-3400.
[14] 梁风,李振龙,侯海利,等.电视胸腔镜辅助小切口管状胃成形在食管癌根治术中的应用[J].武警医学,2017,28(10):999-1001,1004.
[15] 田红刚.单孔胸腔镜小切口根治吻合术治疗胸中段食管癌的临床分析[J].实用肿瘤杂志,2017,32(5):425-430.
[2] 施庆彤.胸腔镜手术与开胸手术治疗食管癌疗效比较[J].山东医药,2015,55(42):61-62.
[3] 宋琦.全胸腔镜手术与传统开胸手术治疗食管癌患者近期临床疗效比较[J].医疗装备,2016,29(6):19-20.
[4] 毛系才,汤井双,周杰.胸腔镜与开胸手术对中老年食管癌术后早期康复的影响[J].山西医药杂志,2017,46(5):554-555.
[5] 太祥,鲍亚男,洪志鹏.胸腔镜下食管癌切除术25例临床病例分析[J].昆明医科大学学报,2016,37(3):57-59.
[6] 毛友生,赫捷,章智荣,等.胸段食管癌经胸腔镜手术与常规开胸手术淋巴结清扫程度的比较[J].中华肿瘤杂志,2015,37(7):530-533.
[7] 李雪益,沃西文,童莉,等.食管癌VATS切除术与开胸切除术术后并发症及预后比较[J].西南国防医药,2015,25(5):496-498.
[8] 李凡,李标,王琼育,等.食管癌患者行胸腔镜切除术后对肺部感染和炎症细胞因子的影响[J].中华医院感染学杂志,2017,27(17):3944-3947.
[9] 李志龙,王一心,臧建洲.不同食管癌根治术对患者术后肺功能及炎性因子水平的影响[J].检验医学与临床,2016,13(6):746-748,751.
[10] 张续民,凤雷.胸腔镜切除术与传统式手术对食管癌术后肺部功能和炎症细胞因子的影响[J].实用癌症杂志,2017,32(10):1617-1620.
[11] 杨博,白传明,肖连波.对比微创食管癌切除术与传统食管胃胸内吻合术对食管癌患者肺功能及炎症细胞因子的影响[J].胃肠病学和肝病学杂志,2015,24(6):720-723.
[12] 李刚,杨双强,刘衡,等.胸腔镜食管癌切除术中行广泛纵隔淋巴结清扫的效果及对术后肺功能的影响[J].河北医学,2015,21(12):1937-1940.
[13] 邓海青,杜正隆,凌毅,等.全胸腔镜与辅助小切口胸腔镜肺癌切除术效果比较[J].现代肿瘤医学,2016,24(21):3398-3400.
[14] 梁风,李振龙,侯海利,等.电视胸腔镜辅助小切口管状胃成形在食管癌根治术中的应用[J].武警医学,2017,28(10):999-1001,1004.
[15] 田红刚.单孔胸腔镜小切口根治吻合术治疗胸中段食管癌的临床分析[J].实用肿瘤杂志,2017,32(5):425-430.