两种弓上吻合途径对食管胸中段癌患者术后肺功能的影响

目的：通过对46例食管胸中段术后患者的回顾性研究，探讨中段食管癌切除经食管床行食管胃主动脉弓上吻合术对呼吸功能的影响。方法：自1999年10月至2002年5月18例中段食管癌患者接受食管癌切除经食管床行食管胃主动脉弓上吻合术与同期20例跨弓行弓上吻合患者，于术后行动态监测血气分析，于术前，术后第一周，二周，四周行肺功能检查。结果：38例患者均手术成功，无死亡，无术后并发症，经食管床组术后对PO2的影响小于同期跨弓行弓上吻合的患者（P＜0．05），术后2周对VC％，FEV1．0％，术后4周对MBC％影响有显著差异（P＜0．05）。结论：经食管床行食管胃主动脉弓上吻合对患者呼吸功能影响小，且更利于防止术后并发症的出现。

Effect of the Thoracic Stomach on Respiratory Function after Esophagectomy and Esophagogastric Anastomosis Following Two Different Ways for Patients with Esophageal Carcinoma in Middle Thoracic Region

Objective:To evaluate the effect of the thoracic stomach on respiratory function after esophagectomy and esophagogastric anastomosis follwing two different ways for patients with esophageal carcinoma in middle thoracic region by reviewing 48 cases.Methods:From October 1999 to May 2002,48 patients with esophageal carcinoma underwent esophagectomy.Eighteen patients underwent esophagogastric anastomosis through esophageal bed while 20 patients were above aortic arch in upper aortic site.All patients were monitored from preoperative day to the 7th day after operation for blood gas analysis and respiratory function before operation,1st week,2nd week,4th week after operation.Results:All patients were survival without anyiel effects.The effect on PO 2 of the patients underwent esophagogastric anastomosis through esophageal bed was lower than the another group( P <0 05).The VC%and FEV1 0% at the 2nd week( P <0 05)and MBC% at the 4th week showed significant difference( P <0 05).Conclusion:Esophagogastric anastomosis through esophageal bed in upper aortic site had little effect on respiratory function than the nother group after esophagectomy.