超声刀对胸腔镜食管癌切除术患者术后疼痛介质及氧化应激指标水平的影响

[目的]探讨应用腔镜下超声刀食管癌切除术对患者术后疼痛介质释放及氧化应激反应的影响.[方法]回顾性分析本院收治的127例食管癌患者的临床资料,根据手术方法的不同将其分为观察组(腔镜下超声刀食管癌切除术,n=65)和对照组(腔镜下电刀食管癌切除术,n=62).比较两组术中情况及并发症发生率,同时比较手术前后两组血清五羟色胺(5-HT)、去甲肾上腺素(NE)及钾离子(K^+)水平,不同时刻超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)水平.[结果]观察组手术时间、术中出血、胸腔引流量均低于对照组,清扫淋巴结数量高于对照组,差异有统计学意义(P<0.05).术后两组血清5-HT、K^+、NE水平高于术前,观察组低于对照组,差异有统计学意义(P<0.05).术毕、术后3 h两组SOD、GSH-Px水平低于术前,MDA水平高于术前,且两组比较差异均有统计学意义(P<0.05).观察组并发症发生率为3.08%(2/65),低于对照组的20.97%(13/62),差异有统计学意义(χ^2=9.75,P<0.05).[结论]腔镜下超声刀食管癌切除术可降低患者疼痛介质、氧化应激产物水平,同时还可优化手术过程,减少术后并发症的发生.

Effect of ultrasonic knife on incision pain and oxidative stress in patients undergoing thoracoscopic resection of esophageal carcinoma

[Objetive]To investigate the efeet of ultrasonic knife on incision pain and oxidative stress in patients with esophageal carcinoma undergoing thoracoscopic resection.[Methods]A total of 127 patients with esophageal cancer admitted to our hospital were selected.65 patients in ultrasonic knife group were treated with ultrasonic knife during thora-coscopic operation,62 patients in control group were treated with electric knife.The intraoperative conditions and the inci-dence of complications were compared between the two groups,and the levels of serum pain medium and oxidative stress at different time before and after operation were compared.[Results]The operation time,intraoperative bleeding and post-operative thoracic drainage in the ultrasonic knife group were significantly lower than those in the control group,and the number of dissected lymph nodes was significantly higher than that in the control group(P<0.05).The serum levels of 5-HT、K^+and NE in the ultrasonic knife group were significantly lower than those in the control group(P<0.05).There was no significant difference in the levels of oxidative stress between the two groups at T,(P>0.05).The level of SOD,GSH-Px in both groups was lower than that at To,and it was higher than that at T.The level of SOD,GSHPx in ultra-sonic knife group was significantly lower than that in control group.The level of MDA was significantly lower than that of control group(P<0.05).The incidence of complications in the ultrasonic knife group was significantly lower than that in the control group(χ^2=9.75,P=0.00).[Conclusion]the thoracoscopic resection of esophageal cancer with ultrasonic knife has the advantages of reducing postoperative pain and reducing the level of oxidative stress products.At the same time,it can optimize the operation process and reduce the incidence of postoperative complications.