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胸腹腔镜联合手术治疗食管癌临床疗效观察

Clinical Observation of Combined Thoracoscopic and Laparoscopic Surgery for Esophageal Cancer
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摘要 【目的】探讨胸腹腔镜联合手术治疗食管癌患者的临床效果。【方法】选取2014年7月至2016年7月来本院诊治的135例食管癌患者,根据手术方式的不同,将其分为观察组和对照组。观察组患者68例,实施胸腹腔镜联合食管癌切除术;对照组患者67例,实施传统开胸手术。比较两组患者的手术相关指标、手术后15d的并发症发生率及术前、术后1d和术后6d免疫功能指标的变化情况。【结果】两组患者的手术时间、气管拔管时间比较差异无统计学意义(P>0.05);观察组的术中出血量、住院时间、禁食时间明显低于对照组,差异有统计学意义(P<0.05)。观察组患者术后15d并发症的发生率明显低于对照组,差异有统计学意义(P<0.05)。术前,两组患者各项免疫功能指标比较差异无统计学意义(P>0.05);术后1d两组患者的各项指标均降低,术后6d各项指标都有所升高,且观察组基本恢复至手术前水平,但对照组还是低于术前;同一时间点,观察组患者各项指标均高于对照组,差异有统计学意义(P<0.05)。【结论】食管癌患者采用胸腹腔镜联合手术治疗临床效果显著,安全可靠,有效地降低了并发症的发生,对患者的免疫功能影响小,有利于术后的恢复。 [Objective] To investigate the clinical effect of combined thoracoscopy and laparoscopy in the treatment of esophageal cancer.[Methods]135 cases of esophageal cancer treated in our hospital from July 2014 to July 2016 were divided into observation group and control group according to the different surgical methods.68patients in the observation group underwent thoracoscopic and laparoscopic resection of esophageal cancer,while 67 patients in the control group underwent traditional thoracotomy.The operation-related indexes,the incidence of complications 15 days after operation and the changes of immune function indexes before operation,1 day after operation and 6 days after operation were compared between the two groups.[Results]There was no significant difference in operation time and tracheal extubation time between the two groups(P>0.05).The bleeding volume,hospital stay and fasting time in the observation group were significantly lower than those in the control group(P<0.05).The incidence of complications in the observation group was significantly lower than that in the control group 15 days after operation(P<0.05).Before operation,there was no significant difference in immune function between the two groups(P>0.05).On the 1st day after operation,the indexes of the two groups decreased,and on the 6th day after operation,the indexes of the observation group basically recovered to the pre-operation level,but the indexes of the control group were still lower than those of the pre-operation.At the same time,the indexes of the observation group were higher than those of the control group,and the difference was statistically significant(P<0.05).[Conclusion]The combined thoracoscopic and laparoscopic surgery for esophageal cancer has remarkable clinical effect,safety and reliability,effectively reduces the occurrence of complications,has little impact on the immune function of patients,and is conducive to the recovery after operation.
作者 黎亮 陈民彪 王德伟 LI Liang;CHEN Min-bico;WANG De-wei(Department of Thoracic Surgery,Hainan General Hospital,Hainan Haikou,570311,China)
出处 《医学临床研究》 CAS 2019年第3期448-450,454共4页 Journal of Clinical Research
关键词 食管肿瘤/外科学 Esophageal Neoplasms/SU
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