摘要
目的观察腋下小切口手术对食管癌患者围术期指标、肺功能恢复及并发症的影响,为临床诊治提供指导。方法选取2017年1月—2018年1月湖北省枣阳市第一人民医院收治的拟行手术治疗的食管癌患者100例,随机分为小切口组(n=50,行腋下小切口手术)和传统组(n=50,行后外侧切口开胸手术);比较两组围术期基本指标、术后并发症情况;分别于术前及术后24 h行血清白细胞介素-8(IL-8)、IL-10、肿瘤坏死因子α(TNF-α)水平,于术前及术后1个月行肺功能检测[最大通气量(MVV)、用力肺活量(FVC)、1秒用力呼气容积(FEV1)]。结果小切口组术中出血量及胸腔开放、单肺通气、术后住院的时间均明显少于传统组(P <0.05)。小切口组肺部感染、肺不张发生率分别为2.00%、4.00%,均明显低于传统组的14.00%、16.00%(P<0.05)。术后24 h,两组血清IL-8、IL-10、TNF-α水平较术前均明显升高(P<0.05),而小切口组明显低于传统组(P<0.05)。术后1个月,小切口组MVV、FVC、FEV1水平均明显高于传统组(P<0.05)。结论腋下小切口手术引起的炎症反应较轻,肺部并发症发生率较低,术后肺功能恢复较快,是治疗食管癌的较理想术式。
Objective To observe the effects of subaxillary small incision surgery on perioperative indexes,pulmonary function recovery and complications in patients with esophageal cancer,and to provide guidance for clinical diagnosis and treatment.Methods 100 patients with esophageal cancer undergoing elective surgery in the hospital from January 2017 to January 2018 were enrolled.They were randomly divided into small incision group(n=50,subaxillary small incision surgery)and traditional group(n=50,posterior-lateral incision thoracotomy).The perioperative basic indexes and postoperative complications were compared between the two groups.The serum interleukin-8(IL-8),IL-10 and tumor necrosis factorα(TNF-α)levels before and at 24 h after surgery were detected.The pulmonary function test was performed before and at 1 month after surgery(maximal voluntary ventilation(MVV),forced vital capacity(FVC),forced expiratory volume in 1 second(FEV1))Results The intraoperative blood loss,open thoracic cavity,single pulmonary ventilation and postoperative hospital stay in small incision group were significantly less than those in traditional group(P<0.05).The occurrence rates of pulmonary infection and atelectasis in small incision group(2.00%and 4.00%)were significantly lower than those in traditional group(14.00%and 16.00%)(P<0.05).At 24 hours after surgery,the levels of serum IL-8,IL-10 and TNF-αin the two groups were significantly increased(P<0.05).The above indexes in small incision group were significantly lower than those in traditional group(P<0.05).1 month after surgery,the levels of MVV,FVC and FEV1 in small incision group were significantly higher than those in traditional group(P<0.05).Conclusion The inflammatory reactions are relatively milder caused by subaxillary small incision surgery.The incidence of pulmonary complications is relatively lower,and the recovery of postoperative pulmonary function is faster.It is an ideal surgical procedure for the treatment of esophageal cancer.
作者
何舟
ZHOU He(First People's Hospital of Zaoyang,Zaoyang 441200,China)
出处
《实用心脑肺血管病杂志》
2019年第S1期49-52,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
食管癌
腋下小切口手术
传统开胸手术
并发症
肺功能
Esophageal cancer
Subaxillary small incision surgery
Traditional thoracotomy
Complication
Pulmonary function
