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胸腹腔镜联合手术和传统开胸手术对食管癌根治术患者肺功能及炎性反应的影响

雷威, 陈会波, 安迎, 黄合超, 余启松, 蒋宝亚, 王鑫波

雷威, 陈会波, 安迎, 黄合超, 余启松, 蒋宝亚, 王鑫波. 胸腹腔镜联合手术和传统开胸手术对食管癌根治术患者肺功能及炎性反应的影响[J]. 实用临床医药杂志, 2020, 24(1): 73-77. DOI: 10.7619/jcmp.202001019
引用本文: 雷威, 陈会波, 安迎, 黄合超, 余启松, 蒋宝亚, 王鑫波. 胸腹腔镜联合手术和传统开胸手术对食管癌根治术患者肺功能及炎性反应的影响[J]. 实用临床医药杂志, 2020, 24(1): 73-77. DOI: 10.7619/jcmp.202001019
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LEI Wei, CHEN Huibo, AN Ying, HUANG Hechao, YU Qisong, JIANG Baoya, WANG Xinbo. Effect of thoracoscopic and laparoscopic surgery in combination versus traditional thoracotomy on pulmonary function and inflammatory response in patients undergoing radical resection of esophageal cancer[J]. Journal of Clinical Medicine in Practice, 2020, 24(1): 73-77. DOI: 10.7619/jcmp.202001019
Citation: LEI Wei, CHEN Huibo, AN Ying, HUANG Hechao, YU Qisong, JIANG Baoya, WANG Xinbo. Effect of thoracoscopic and laparoscopic surgery in combination versus traditional thoracotomy on pulmonary function and inflammatory response in patients undergoing radical resection of esophageal cancer[J]. Journal of Clinical Medicine in Practice, 2020, 24(1): 73-77. DOI: 10.7619/jcmp.202001019
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胸腹腔镜联合手术和传统开胸手术对食管癌根治术患者肺功能及炎性反应的影响

  • 河南省洛阳新区人民医院, 1. 麻醉科;

  • 2. 普胸外科, 河南 洛阳, 471023

基金项目: 

河南省洛阳市科学技术局基金项目(NO1603001A-11)

详细信息

  • 中图分类号: R735.1

Effect of thoracoscopic and laparoscopic surgery in combination versus traditional thoracotomy on pulmonary function and inflammatory response in patients undergoing radical resection of esophageal cancer

  • 1. Anesthesiology Department;

  • 2. Department of General Thoracic Surgery, New District People's Hospital of Luoyang City, Luoyang, He'nan, 471023

摘要

    摘要
  • 摘要: 目的 对比胸腹腔镜联合手术与传统开胸手术对食管癌根治术患者肺功能及炎性反应的影响。 方法 选取200例行食管癌根治术的患者作为研究对象,根据术式不同将患者分为腔镜组(行胸腹腔镜联合手术)和开胸组(行传统开胸手术),各100例。对2组患者手术前后肺功能指标［用力呼气量占预计值百分比(FEV%)、第1秒用力呼气量占预计值百分比(FEV1%)、用力肺活量占预计值百分比(FVC%)、每分钟最大通气量占预计值百分比(MVV%)和肺活量占预计值百分比(VC%)］及炎性因子指标［白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)］进行对比。 结果 2组患者的手术时间和清扫淋巴结数量比较,差异无统计学意义(P>0.05); 腔镜组患者术中出血量少于开胸组,差异有统计学意义(P<0.05)。术前, 2组患者FEV%、FEV1%、FVC%、MVV%、VC%比较,差异无统计学意义(P>0.05); 术后24 h, 腔镜组患者FEV%、FEV1%、FVC%、MVV%、VC%水平均高于对照组,差异有统计学意义(P<0.05)。术前, 2组患者IL-6、IL-8、IL-10水平比较,差异无统计学意义(P>0.05); 术后24、48 h, 腔镜组患者IL-6、IL-8、IL-10水平均低于开胸组,差异有统计学意义(P<0.05)。 结论 与传统开胸手术相比,胸腹腔镜联合手术更加有利于保护食管癌根治术患者的肺功能,并能减少炎性因子的释放,对患者机体损伤更小。
    Abstract: Objective To investigate the effect of thoracoscopic and laparoscopic surgery in combination and traditional thoracotomy on pulmonary function and inflammatory response in patients undergoing radical resection of esophageal cancer. Methods A total of 200 patients with esophageal cancer who underwent radical resection were selected as study subjects, and were divided into endoscopy group(thoracoscopic and laparoscopic surgery in combination, n=100)and thoracotomy group(conventional thoracotomy, n=100)according to the different operative methods. The pulmonary function indexes ［ratio of forced expiratory volume to predicted(FEV%), ratio of forced expiratory volume in one second to predicted value(FEV1%), ratio of forced vital capacity value(FVC%), ratio of maximum ventilation volume per minute to predicted value(MVV%)and ratio of vital capacity to predicted value(VC%)］before and after operation and inflammatory factor indexes［interleukin-6(IL-6), interleukin-8(IL-8), interleukin-10(IL-10)］were compared between the two groups. Results There were no significant differences in operation time and number of lymph nodes dissected - between the two groups(P>0.05), while the amount of bleeding in endoscopy group was significantly less than that in thoracotomy group(P<0.05). There were no significant differences in FEV%, FEV1%, FVC%, MVV% and VC% between the two groups before operation(P>0.05), and the indicators including FEV%, FEV1%, FVC%, MVV% and VC% in the endoscopy group at 24 h after operation were higher than those in the control group(P<0.05). There were no significant differences in the levels of IL-6, IL-8 and IL-10 between the two groups before operation(P>0.05), and the levels of IL-6, IL-8 and IL-10 in endoscopy group were lower than those in thoracotomy group at 24 and 48 hours after operation(P<0.05). Conclusion Compared with traditional thoracotomy, thoracoscopic and laparoscopic surgery in combination is more conducive to protecting the lung function of patients undergoing radical esophagectomy, and can reduce the release of inflammatory factors, and has less damage to the body.
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    • 参考文献(15)

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出版历程
  • 收稿日期:  2019-10-11
  • 网络出版日期:  2020-12-22
  • 发布日期:  2020-08-06

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