摘要
目的 探讨根治手术与左胸Sweet手术治疗中下段食管癌对患者肺功能的影响。方法 选取2018年8月至2022年8月在中国人民解放军总医院第八医学中心诊治的中下段食管癌患者144例作为研究对象,根据随机信封抽签原则把患者分为Sweet组与对照组各72例。Sweet组给予左胸Sweet手术治疗,对照组给予根治手术治疗,观察与记录患者肺功能变化情况。结果 2组手术时间、术中出血量、淋巴结清扫数等对比,差异无统计学意义(P>0.05),Sweet组的术后引流管留置时间、术后住院时间比对照组短,差异有统计学意义(P<0.05)。Sweet组术后14 d的肺部感染、肺不张、吻合口瘘、吻合口狭窄等并发症发生率为2.8%,显著低于对照组的13.9%(P<0.05)。Sweet组与对照组术后3个月的第1秒用力呼气容积、第1秒用力呼气容积占用力肺活量的比例与术前1 d对比,差异有统计学意义(P<0.05),Sweet组术后3个月第1秒用力呼气容积、第1秒用力呼气容积占用力肺活量的比例高于对照组,差异有统计学意义(P<0.05)。Sweet组术后3个月的吞咽困难、进食障碍、反流、疼痛、味觉障碍等生活质量评分都低于对照组,差异有统计学意义(P<0.05)。所有患者随访到2023年4月1日,随访时间为(23.10±1.19)个月,Sweet组的复发率为1.4%,显著低于对照组的9.7%(P<0.05)。结论 相对于根治手术,左胸Sweet手术治疗食管癌患者并不会增加手术难度,还可缩短患者的术后引流管留置时间、术后住院时间,降低患者的并发症发生率,有利于患者肺功能的恢复,提高患者的生活质量,降低患者的复发率。
Objective To explore and compare the effects of radical surgery and left chest Sweet surgery on lung function in patients with esophageal cancer.Methods From August,2018 to August,2022,144 cases of patients with esophageal cancer who were diagnosed and treated at the Eighth Medical Center of PLA General Hospital were selected as the research subjects.Accorded to the principle of random envelope drawing,the patients were divided into the Sweet group and the control group,with 72 patients in each group.The Sweet group were received left chest Sweet surgery,while the control group were received radical surgery.The changes in lung function of the patients were observed and recorded.Results There was no significant difference in surgical time,intraoperative bleeding,and lymph node dissection between the two groups(P>0.05).The Sweet group had significantly shorter postoperative drainage tube retention time and hospitalization time than the control group(P<0.05).The incidence of complications such as pulmonary infection,atelectasis,anastomotic fistula,and anastomotic stenosis in the Sweet group 14 days after surgery was 2.8%,which was significantly lower than the 13.9%in the control group(P<0.05).There was significant difference in the forced exhalation volume and rate in one second cpompared between the Sweet group and the control group at 3 months after surgery compared to the day before surgery(P<0.05).The forced exhalation volume and rate in one second in the Sweet group at 3 months after surgery were also significantly increased compared to the control group(P<0.05).The quality of life scores of swallowing difficulties,eating disorders,reflux,pain,and taste disorders in the Sweet group were significantly lower than those in the control group at 3 months after surgery(P<0.05).All patients were followed up until April 1,2023,with the average follow-up time of(23.10±1.19)months.The recurrence rate in the Sweet group was 1.4%,significantly lower than that(9.7%)in the control group(P<0.05).Conclusions Compared to radic
作者
周爱国
郑梦利
张书新
赵亚超
周鹏宇
张建
郑明
Zhou Aiguo;Zheng Mengli;Zhang Shuxin;Zhao Yachao;Zhou Pengyu;Zhang Jian;Zheng Ming(Department of Thoracic Surgery,the Eighth Medical Center of PLA General Hospital,Beijing 100091,China)
出处
《中国临床保健杂志》
CAS
2023年第6期752-756,共5页
Chinese Journal of Clinical Healthcare
关键词
食管肿瘤
肺
胸腔镜检查
手术后并发症
生活质量
Esophageal neoplasms
Lung
Thoracoscopy
Postoperative complications
Quality of life
