摘要
目的探讨胸腔镜食管癌根治术联合左侧颈部吻合术治疗食管癌的临床效果。方法选择2018年1月至2020年12月新乡医学院第三附属医院收治的80例食管癌患者为研究对象,根据手术方法将患者分为对照组(n=38)和观察组(n=42)。对照组患者行常规经右胸食管癌切除术联合胃食管胸内吻合术治疗,观察组患者行胸腔镜食管癌根治术联合左侧颈部吻合术治疗。记录2组患者术中出血量、手术时间、淋巴结清扫个数、拔管时间、总引流量、住院时间。分别于术前及术后12、24、48、72 h,采用视觉模拟评分(VAS)评估患者疼痛情况。分别于术前、术后4周,采用肺功能仪检测患者肺功能相关指标,包括第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、肺活量(VC)、最大通气量(MVV),并计算FEV_(1)/FVC。分别于术前、术后4周,采用酶联免疫吸附法检测患者血清中一氧化氮合酶(NOS)、可溶性白细胞介素-2受体(SIL-2R)水平,采用放射免疫分析法检测患者血清中癌胚抗原(CEA)水平。记录2组患者术后并发症发生情况。结果2组患者淋巴结清扫个数比较差异无统计学意义(P>0.05);观察组患者术中出血量、总引流量显著少于对照组,拔管时间、住院时间显著短于对照组,手术时间显著长于对照组(P<0.05)。术前2组患者的VAS评分比较差异无统计学意义(P>0.05);2组患者术后12、24、48、72 h VAS评分呈下降趋势(P<0.05);2组患者术后12、24、48、72 h VAS评分均显著低于术前(P<0.05);术后12、24、48、72 h,观察组患者的VAS评分均显著低于对照组(P<0.05)。术前2组患者的VC、MVV、FEV_(1)、FEV_(1)/FVC比较差异均无统计学意义(P>0.05);2组患者术后4周的VC、MVV、FEV_(1)、FEV_(1)/FVC均显著低于术前(P<0.05);术后4周,观察组患者的VC、MVV、FEV_(1)、FEV_(1)/FVC均显著高于对照组(P<0.05)。术前2组患者血清NOS、CEA、SIL-2R水平比较差异无统计学意义(P>0.05);2组�
Objective To investigate the curative effect of thoracoscopic radical resection of esophageal cancer combined with left neck anastomosis in the treatment of esophageal cancer.Methods Eighty patients with esophageal cancer admitted to the Third Affiliated Hospital of Xinxiang Medical University from January 2018 to December 2020 were selected as the research objects,and the patients were divided into the control group(n=38)and the observation group(n=42)according to the surgical methods.The patients in the control group were treated with conventional right thoracic esophagectomy combined with gastroesophageal anastomosis,and the patients in the observation group were treated with thoracoscopic radical esophagectomy combined with left neck anastomosis.The intraoperative blood loss,operation time,the number of removed lymph nodes,extubation time,total drainage volume and hospital stay time of patients in the two groups were recorded.The pain status of patients was evaluated by visual analogue scale(VAS)before operation and at 12,24,48,72 hours after operation.Before operation and 4 weeks after operation,pulmonary function-related indicators of patients were detected by spirometer,including forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC),vital capacity(VC),maximum voluntary ventilation(MVV),and the FEV_(1)/FVC was calculated.Before operation and 4 weeks after operation,the levels of serum nitric oxide synthase(NOS),soluble interleukin-2 receptor(SIL-2R)were detected by enzyme linked immunosorbent assay,and the level of carcinoembryonic antigen(CEA)in serum was detected by radioimmunoassay.The incidence of postoperative complications of patients in the two groups was recorded.Results There was no significant difference in the number of removed lymph nodes of patients between the two groups(P>0.05);the intraoperative blood loss and the total drainage volume of patients in the observation group were significantly lower than those in the control group(P<0.05);the extubation time and the hospita
作者
樊宏哲
郭浩
杜鹏程
FAN Hongzhe;GUO Hao;DU Pengcheng(Department of Cardiothoracic Surgery,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China;Department of Intensive Care Medicine,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China;Department of Gastroenterology,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China)
出处
《新乡医学院学报》
CAS
2022年第5期439-444,449,共7页
Journal of Xinxiang Medical University
关键词
胸腔镜食管癌根治术
左侧颈部吻合术
食管癌
肺功能
一氧化氮合成酶
癌胚抗原
可溶性白细胞介素-2受体
thoracoscopic radical resection of esophageal cancer
left neck anastomosis
esophageal cancer
lung function
nitric oxide synthase
carcinoembryonic antigen
soluble interleukin-2 receptor
