三腔喂养管联合管状胃治疗老年食管癌的临床效果分析

目的比较三腔喂养管联合管状胃与传统手术方法治疗老年食管癌患者的临床效果。方法选取2007年1月至2013年1月绵阳市中心医院胸心外科收治的196例年龄大于60岁的食管癌患者,按手术方式不同分为三腔喂养管联合管状胃组（A组）和传统手术组（B组）。A组96例,男51例、女45例,年龄（66.21±7.32）岁;B组100例,男54例、女46例,年龄（65.43±6.37）岁。比较两组患者的临床指标。结果两组患者均顺利完成根治手术。两组患者手术时间、术中出血量、术后乳糜胸、术后喉返神经麻痹、吻合口瘘、吻合口狭窄发生率及死亡率等临床指标差异无统计学意义（P〉0.05）。A组肛门排气时间和住院时间较B组显著缩短,术后心律失常、肺部并发症、胸胃综合征发生率较B组显著降低（P〈0.05）。结论三腔喂养管空肠营养联合管状胃在老年食管癌手术中通过围手术期治疗可以降低部分并发症发生率,可缩短住院时间和改善患者的生活质量。

Clinical Outcomes of Triluminal-tube Feeding with Tubular Stomach for the Treatment of Esophageal Carcinoma in Elderly Patients

Objective To compare clinical outcomes between triluminal-tube feeding combined with tubular stom- ach and traditional esophagectomy for the treatment of esophageal carcinoma （EC） in elderly patients. Methods A total of 196 elderly patients （ 〉 60 years）with EC who received esophagectomy in the Department of Cardiothoracie Surgery, Mianyang Central Hospital from January 2007 to January 2013 were enrolled in this study. According to different surgical methods, all the patients were divided into triluminal-tube feeding combined with tubular stomach group （group A） and traditional esophagectomy group （group B）. There were 96 patients including 51 males and 45 females in group A with their age of 60-81 （66.21-±7.32） years, and 100 patients including 54 males and 46 females in group B with their age of 60-82 （65.43 ± 6.37） years. Clinical indexes were compared between the 2 groups. Results Radical esophagectomy was successfully performed for all the patients. There was no statistical difference in operation time, intraoperative blood loss, postoperative incidence of chylothorax, recurrent laryngeal nerve paralysis, anastomotic leakage, anastomotic stricture or mortality between the 2 groups （P ：〉 0.05）. Time to first passage of flatus and postoperative length of hospital stay of group A were significantly shorter than those of group B, and the incidences of postoperative arrhythmias, pulmonary complications and thoracic-stomach syndrome of group A were significantly lower than those of group B （P 〈 0.05）. Conclusion Triluminal-tube feeding combined with tubular stomach can significantly reduce postoperative morbidity, shorten hospital stay and improve quality of life of elderly patients undergoing esophagectomy.