摘要
目的 观察不同手术入路对食管癌根治术病人并发症及肿瘤标志物水平的影响。方法 2019年10月~2022年10月行根治术治疗的食管癌病人100例,采用随机数表法分为观察组和对照组,每组各50例,观察组使用右胸入路手术治疗,对照组使用左胸入路手术治疗。比较两组围术期指标、手术前后炎症因子[P物质(SP)、超敏C反应蛋白(hs-CRP)、白细胞介素(IL)-6]、肿瘤标志物[细胞角蛋白19片段抗原(CYFRA21-1)、鳞状细胞癌抗原(SCC-Ag)以及糖类抗原199(CA199)]、肺功能指标[肺活量(VC)、用力肺活量(FVC)以及第1秒用力呼气容积(FEV1)]以及并发症发生率。结果 观察组手术时间、失血量、留置胸管时间、住院时间以及淋巴结清扫数目分别为(247.65±27.33)分钟、(211.82±25.49)ml、(6.97±2.12)天、(16.11±3.81)天、(19.67±5.21)枚,均高于对照组[(217.63±23.69)分钟、(175.67±22.13)ml、(5.43±1.80)天、(12.68±3.24)天、(15.45±4.12)枚],差异有统计学意义(P<0.05);术后3天两组SP、hs-CRP、IL-6水平均有显著上升,差异有统计学意义(P<0.05),观察组术后3天SP、hs-CRP、IL-6水平分别为(273.96±35.45)ng/L、(11.35±2.12)mg/L、(8.19±1.67)μg/ml,低于对照组[(298.33±38.42)ng/L、(14.29±2.68)mg/L、(10.35±1.82)μg/ml],差异有统计学意义(P<0.05);术后1个月两组CYFRA21-1、SCC-Ag、CA199均有显著下降,差异有统计学意义(P<0.05),且观察组术后1个月CYFRA21-1、SCC-Ag、CA199分别为(2.59±0.37)μg/L、(45.62±6.18)μg/L、(59.37±6.12)U/ml低于对照组[(3.12±0.43)μg/L、(60.27±7.35)μg/L、(63.28±6.49)U/ml],差异有统计学意义(P<0.05);术后1个月两组VC、FVC、FEV1均显著下降,但观察组术后1个月VC、FVC、FEV1分别为(67.21±8.69)%、(70.33±9.41)%、(72.88±10.12)%高于对照组[(54.35±8.27)%、(61.65±8.79)%、(65.37±9.24)%],差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论 两种入路方式均可有效治疗食�
Objective To observe the effects of different surgical approaches on the complications and tumor markers of patients undergoing radical resection of esophageal cancer.Method A prospective study was conducted on 100 patients with esophageal cancer who underwent radical surgery in our hospital from October 2019 to October 2022.They were randomly divided into an observation group and a control group using a random number table method,with 50 patients in each group,he right thoracic approach was used in the observation group and the left thoracic approach was used in the control group.Perioperative indexes,inflammatory factors[Substance P(SP),hypersensitive C-reactive protein(hs-CRP),interleukin6(IL-6)],tumor markers[cytokeratin 19 fragment antigen(CYFRA21-1),squamous cell carcinoma antigen(SCC-Ag)and carbohydrate antigen 199(CA199)]and lung function of the two groups were compared before and after surgery Indicators[vital capacity(VC),forced vital capacity(FVC),and forced expiratory volume in the first second(FEV 1)]and complication rate.Result The operating time,blood loss,indwelling time,hospitalization time,and number of lymph node dissection in the observation group were(247.65±27.33)minutes,(211.82±25.49)ml,(6.97±2.12)days,(16.11±3.81)days,and(19.67±5.21),respectively,which were higher than those in the control group[(217.63±23.69)minutes,(175.67±22.13)ml,(5.43±1.80)days,(12.68±3.24)days,(15.45±4.12)](P<0.05).On average,there was a significant increase in SP,hs CRP,and IL-6 levels in both groups 3 days after surgery(P<0.05).The levels of SP,hs CRP,and IL-6 in the observation group were(273.96±35.45)ng/L,(11.35±2.12)mg/L,and(8.19±1.67)μg/ml,respectively,which were lower than the control group[(298.33±38.42)ng/L,(14.29±2.68)mg/L,(10.35±1.82)μg/ml](P<0.05);One month after surgery,there was a significant decrease in CYFRA21-1,SCC-Ag,and CA199 in both groups(P<0.05),and in the observation group,the data of CYFRA21-1,SCC-Ag,and CA199 were(2.59±0.37)μg/L,(45.62±6.18)μg/L and(59.37±6.12)U/ml,resp
作者
刘胜凯
崔丽娜
李俊鹏
石俊杰
范艳玲
LIU Shengkai;CUI Lina;LI Junpeng;SHI Junjie;FAN Yanling(Handan First Hospital,Han Dan,Hebei 056000,China)
出处
《临床外科杂志》
2024年第6期603-606,共4页
Journal of Clinical Surgery
基金
河北省邯郸市科学技术研究与发展计划项目(22422083072ZC)。
关键词
右胸入路
左胸入路
食管癌
肺功能
并发症
right thoracic approach
left thoracic approach
esophageal cancer
lung function
complication
