两种手术路径对食管癌患者围手术期呼吸功能的影响

目的:探讨胃代食管颈部吻合的两种手术路径对胸中上段食管癌患者围手术期呼吸功能的影响。方法:选择行胃代食管颈部吻合患者38例,经胸骨后颈部吻合16例(胸骨后组),经食管床颈部吻合22例(食管床组)。监测两组患者围手术期肺功能及血气分析的主要指标。结果:两组患者肺活量占预计值百分比(VC%)、第1秒用力呼气量占预计值百分比(FEV1%)、动脉血氧分压(PaO2)术后均出现不同程度的降低。与胸骨后组比较,食管床组VC%和PaO2在手术5 d后降低更为明显(P<0.05),而FEV1%在术后第7天后降低更为显著(P<0.05)。结论:胸中上段食管癌切除术后,经食管床颈部吻合较经胸骨后颈部吻合对围手术期呼吸功能的影响更大。

Effects of different surgical pathways on perioperative respiratory function for patients with esophageal carcinoma

Objective To explore the effects of two operations on perioperative respiratory function after cervical esophagogastrostomy for patients with esophageal carcinoma.Methods Thirty eight patients with esophageal cancer underwent cervical esophagogastrostomy were retrospectively analyzed.The site of esophageal anastomosis was at neck after sternum in 16 cases,and at neck through esophageal bed in other 22 cases.Blood gas analysis and pulmonary function were monitored in these patients before operation and in 14 days after operation.Results For percentage of predicted vital capacity（VC%）,forced expiratory volume in 1 second percentage of predicted value（FEV1%） and arterial oxygen pressure（PaO2） after surgery in two group patients,there are different degrees of reduction.Compared with group sternum,VC% and PaO2 decreased significantly 5 days after surgery in group esophageal bed（P〈0.05）,and FEV1% reduction in postoperative day 7 is particularly significant（P〈0.05）.Conclusion After esophagectomy,cervical esophagogastrostomy through esophageal bed has significant negative effect on perioperative respiratory function.