微创食管癌根治术与传统根治术治疗合并COPD的食管癌患者术后肺功能比较

目的比较微创食管癌根治术与传统根治术治疗食管癌合并慢性阻塞性肺疾病(COPD)术后肺功能的影响。 方法选择2017年2月至2019年2月期间接受临床治疗的138例食管癌合并COPD患者进行临床研究，通过随机数表法将患者分为传统组(n＝69)和微创组(n＝69)，传统组患者给予传统根治术治疗，微创组患者给予微创食管癌根治术治疗。采用SPSS20.0统计软件进行分析。各项肺功能指标和手术情况等采用( ±s)的方式来表示，采用独立样本t检验；术后并发症发生率采用χ²检验；呼吸困难指数(MRC)分级采用秩和检验；P<0.05差异有统计学意义。 结果与传统组相比，微创组MRC轻度患者比例明显提高，重度患者比例明显下降(P<0.05)；微创组的肺弥散容量(DLco/SB)和每单位肺容积时的肺弥散量(DLco/VA)指标均明显升高，两组的用力肺活量(FVC)和第1秒用力呼气容积占用力肺活量比值(FEV1/FVC)等指标差异无统计学意义(P>0.05)。与传统组比，微创组的手术时间、手术出血量、术后引流时间和术后住院时间均明显下降(P<0.05)，肺部并发症发生率明显下降(χ²＝10.817, P＝0.001)，两组的手术清扫淋巴结数差异无统计学意义(P>0.05)。 结论微创食管癌根治术治疗食管癌合并COPD患者，可明显改善食管癌合并COPD患者的肺功能，同时其手术情况以及术后肺部并发症的发生情况均得到明显改善。

Comparison of pulmonary function between minimally invasive radical resection and traditional radical resection for the treatment of esophageal cancer complicated with COPD

ObjectiveTo compare the effects of minimally invasive radical resection and traditional radical resection on pulmonary function in patients with esophageal cancer complicated with Chronic Obstructive Pulmonary Disease (COPD). Methods138 patients with esophageal cancer complicated with COPD treated in our hospital from February 2017 to February 2019 were selected for clinical study. The patients were divided into control group (n=69) and observation group (n=69) by random number table method. The patients in control group were treated with traditional radical operation, while those in observation group were treated with minimally invasive radical operation for esophageal cancer. SPSS20.0 statistical software was used for analysis. The independent sample t test was used to compare the static pulmonary function indicators and surgical conditions of the two groups, and the data was shown by. The χ² test was used to compare the MRC grading and postoperative pulmonary complications of the two groups. ResultsCompared with the control group, the proportion of patients with mild MRC in the observation group increased significantly, and the proportion of patients with severe MRC decreased significantly (P<0.05). Compared with the control group, the lung diffusive capacity (DLco/SB) and the lung diffusive volume (DLco/VA) per unit lung volume in the observation group were significantly higher, while the forced vital capacity (FVC) and the first second forced expiratory volume occupied forced vital capacity ratio (FEV1/FVC) in the two groups had no statistical significance (P>0.05). Compared with the control group, the operation time, bleeding volume, drainage time and hospitalization time of the observation group were significantly decreased (P<0.05), and there was no significant difference in the number of lymph nodes dissected between the two groups (P>0.05). Compared with the control group, the incidence of pulmonary complications in the observation group decreased significantly(χ²=10.817, P=0.001). ConclusionCompared with traditional radical surgery, minimally invasive radical resection of esophageal cancer can significantly improve pulmonary function in patients with esophageal cancer and COPD. Meanwhile, the intraoperative and postoperative pulmonary complications were significantly improved.