胸腔镜根治术对老年食管癌患者术后肺部感染与呼吸功能及炎症因子的影响

目的探讨胸腔镜根治术对老年食管癌患者术后肺部感染与呼吸功能及炎症因子的影响。方法选择100例行手术治疗的食管癌患者的临床资料进行回顾性分析,根据手术方法分为胸腔镜组60例与开胸组40例。比较2组术后肺功能、外周炎症因子水平以及肺部感染发生率。结果(1)2组术后24 h外周血炎症因子IL-6、IL-8、IL-10以及TNF-α均显著升高(P<0.05),但开胸组显著高于胸腔镜组(P<0.05);术后1周,2组外周血炎症因子水平均显著下降,2组间比较差异无统计学意义(P>0.05)。(2)术后1个月,开胸组患者FEV1、FEV1/FVC FVC均显著低于胸腔镜组,差异有统计学意义(P<0.05)。(3)术后3天开胸组CRP水平、WBC水平、体温以及呼吸频率均显著高于胸腔镜组,差异有统计学意义(P<0.05)。(4)胸腔镜组术后无肺部感染,开胸组有4例(10.0%)发生肺部感染,2组比较差异有统计学意义(P<0.05)。结论与传统开胸手术比较,胸腔镜食管癌根治术对老年患者呼吸功能、外周血炎症因子的影响相对较小,术后患者肺部感染发生率更低。

Effect of Thoracoscopic Radical Resection on Pulmonary Infection,Respiratory Function and Inflammatory Factors in Elderly Patients with Esophageal Cancer after Operation

Objective To discuss the effect of thoracoscopic radical resection on pulmonary infection,respiratory function and inflammatory factors in elderly patients with esophageal cancer after operation.Methods Clinical data of 100 patients with esophageal cancer who underwent surgical treatment were retrospectively analyzed.According to the operation method,60 cases were divided into thoracoscopic group and 40 cases into thoracotomy group.The pulmonary function,the level of peripheral inflammatory factors and the incidence of pulmonary infection were compared between the two groups.Results(1)The levels of IL-6,IL-8,IL-10 and TNF-alpha in peripheral blood of the two groups were significantly increased 24 hours after operation(P<0.05),but the levels of IL-6,IL-8,IL-10 and TNF-alpha in thoracotomy group were significantly higher than those in thoracoscopy group(P<0.05);One week after operation,the levels of inflammatory factors in peripheral blood of both groups decreased significantly,and there was no significant difference between the two groups(P>0.05).(2)One month after operation,FEV1 and FEV1/FVC FVC in thoracotomy group were significantly lower than those in thoracoscopy group(P<0.05).(3)The levels of CRP,WBC,body temperature and respiratory rate in thoracotomy group were significantly higher than those in thoracoscopy group 3 days after operation(P<0.05).(4)There was no pulmonary infection in the thoracoscopic group and 4 cases in the thoracotomy group.The incidence of pulmonary infection in the thoracotomy group was 10.0%.There was significant difference between the two groups(P<0.05).Conclusion Compared with traditional thoracotomy,thoracoscopicesophagectomy has less influence on respiratory function and inflammatory factors in peripheral blood of elderly patients,and the incidence of pulmonary infection is lower in patients after thoracoscopicesophagectomy.