负压封闭引流技术在食管癌切除术后的应用

目的 探讨负压封闭引流技术（vacuum sealing drainage,VSD）在食管癌切除术后治疗中的临床应用.方法 56例食管癌患者随机分为两组：观察组30例,采用VSD引流;对照组26例,采用常规方法引流.观察患者的引流量、血浆白细胞介素6（IL-6）、术后并发症、恢复进食时间、拔管时间、术后住院天数等.结果 术后观察组第1、2、3、4天总引流量分别为（410±177;20）、（630±177;22）、（720±177;17）、（750±177;19）mL,对照组分别为（420±177;30）、（680±177;27）、（770±177;31）、（800±177;33）mL,观察组第2、3、4天的引流量较对照组少,差异具有统计学意义（P〈0.05）;术后第2天和第3天血浆IL-6浓度,观察组为（12.47±177;5.54）、（9.68±177;4.21）mol/L,对照组为（16.45±177;7.69）、（13.21±177;6.94）mol/L,差异有统计学意义（P＆lt;0.05）;术后并发症总例数,观察组为5例（占16.7%）,对照组5例（占19.2%）,差异无统计学意义（P＞0.05）;术后进食时间,观察组（5.7±177;1.5）d,对照组（7.1±177;1.9）d,差异有统计学意义（P〈0.05）;术后拔管时间,观察组为（6.1±177;0.9）d,对照组（6.9±177;1.5）d,差异有统计学意义（P＆lt;0.05）;术后住院天数,观察组（11.2±177;1.1）d,对照组（12.5±177;1.5）d,差异有统计学意义（P〈0.05）;住院费用,观察组（46 294±177;3 365）元,对照组（48 962±177;3 892）元,差异有统计学意义（P〈0.05）.结论 应用VSD进行食管癌切除术后引流,术后恢复快,可明显缩短住院时间,降低住院费用,有良好的临床推广应用价值.

Application of vacuum sealing drainage in post-esophagectomy

Objective To investigate the application of vacuum sealing drainage in post-esophagectomy. Methods Fifty- six patients with post-esophagectomy were randomly allocated into two groups including study group （n=30）, in which patients were treated by VSD, and control group （n= 26）, in which patients were treated by normal drainage according to the traditional method. The indexes were investigated which included drainage volume, postoperative complications, time of post-operative food intake, time of extubation and postoperative hospital stay. Results In study group and control group, the drainage vol- ume after 1 day, 2 day, 3 day and4 day was （410±20）, （630±22）, （720±17） and （750±19） mLvs （420±30）, （680±27）, （770±31） and （800±33） mL, the difference between tow groups in two day, three day, and four day was statistically significant （P〈0.05）, Concentration of IL-6 after two day and three day was （12.47±5.54）, （9.68±4.21） mol/L vs （16.45 ±7.69）, （13.21 ±6.94） tool/L, P〈0.05） The number of patients got post-operative complications was five vs five （P〉 0.05）. Time of post-operative food intake was （5.7±1.5） d vs （7.1± 1.9） d （P〈0.05）. Time of extubation was （6.1±0.9） d vs （3.9±1.5） d （P〈0.05）. Postoperative hospital stay was （11.2±1.1） d vs （12.5±1.5） d （P〈0.05）. The cost of hospitalization was （46 294±3 365） yuan vs （48 926±3 892） yuan （P〈0.05）. Conclusion The treatment for post-esoph- agectomy by VSD has the advantages of good curative effect, shortening hospital day and decreasing cost of hospitalization. This suggests that the therapeutic measure has a value to manage post-esophagectomy.