研究胸腹腔镜微创手术对食管癌患者术后肺部感染及肺功能的影响

目的探讨食管癌患者应用胸腹腔镜微创手术以及开胸手术两种方式对患者术后肺部感染及肺功能所造成的影响。方法50例食管癌患者,依照治疗方式不同分为对照组以及观察组,每组25例。对照组患者应用开胸手术进行治疗,观察组患者则应用胸腹腔镜微创手术进行治疗。对比两组患者手术时间、淋巴结清扫数量、出血量、住院时间、术后肺部感染情况及肺功能指标[第1秒用力呼气容积占用力肺活量比值(FEV1/FVC)、第1秒用力呼气容积(FEV1)]水平。结果观察组患者的手术时间(4.29±0.81)h显著长于对照组的(3.32±0.78)h,淋巴结清扫数量(44.02±6.14)个显著多于对照组的(31.05±4.32)个,差异具有统计学意义(P<0.05);观察组患者的住院时间(9.45±1.74)d显著短于对照组的(16.02±2.86)d,出血量(221.52±30.29)ml少于对照组的(368.67±40.35)ml,差异具有统计学意义(P<0.05)。观察组患者术后肺部感染率8.00%(2/25)显著低于对照组的32.00%(8/25),差异具有统计学意义(P<0.05)。术后,观察组患者的FEV1、FEV1/FVC水平均显著优于对照组,差异具有统计学意义(P<0.05)。结论与开胸手术方式对比,胸腹腔镜微创手术应用于食管癌治疗其优势更大,而且手术过程当中的创伤明显更小,能够降低术后患者肺部感染发生率,改善患者肺功能,患者预后也明显更好,具有良好的临床推广应用价值。

Study the effect of thoracoscopic and laparoscopic minimally invasive surgery on postoperative pulmonary infection and pulmonary function in patients with esophageal cancer

Objective To discuss the effect of thoracoscopic and laparoscopic minimally invasive surgery and thoracotomy on postoperative pulmonary infection and pulmonary function in patients with esophageal cancer. Methods A total of 50 patients with esophageal cancer were divided into control group and observation group according to different treatment methods, with 25 cases in each group. The control group was treated with thoracotomy, and the observation group was treated with thoracoscopic and laparoscopic minimally invasive surgery. The operation time, number of lymph node dissections, blood loss, hospitalization time, postoperative lung infection and lung function indicators [forced expiratory volume in the first second/forced vital capacity(FEV1/FVC), FEV1] level were compared between the two groups. Results The operation time(4.29±0.81) h of the observation group was significantly longer than(3.32±0.78) h of the control group, and number of lymph node dissections(44.02±6.14) nodes was significantly more than(31.05±4.32) nodes of the control group, and the difference was statistically significant(P<0.05). The hospitalization time(9.45±1.74) d of the observation group was significantly shorter than(16.02±2.86) d of the control group, and blood loss(221.52±30.29) ml was less than(368.67±40.35) ml of the control group, and the difference was statistically significant(P<0.05). The incidence of postoperative lung infection 8.00%(2/25) of the observation group was significantly lower than 32.00%(8/25) of the control group, and the difference was statistically significant(P<0.05). After operation, the FEV1 and FEV1/FVC of the observation group was significantly better than those of the control group, and the difference was statistically significant(P<0.05). Conclusion Compared with thoracotomy, thoracoscopic and laparoscopic minimally invasive surgery has greater advantages in the treatment of esophageal cancer, and the trauma during the operation is significantly smaller, and can reduce the incidence of lung infections in patients after operation, and impoprve the lung function, and the prognosis of patients is significantly better. It has good clinical application value.