不同手术方式对食管癌患者肺功能、免疫功能及应激反应的影响

Effect of different esophagectomy on pulmonary function, immune function and stress response of esophageal cancer patients

目的探讨胸腹腔镜食管癌根治术与开放食管癌根治术对患者肺功能、免疫功能、应激反应的影响。方法选取食管癌患者80例,根据不同的手术方法分为两组。对照组40例采用开放食管癌根治术治疗,观察组40例采用胸腹腔镜食管癌根治术治疗,比较两组治疗前后的肺功能、应激反应、免疫功能水平等变化。结果两组治疗第1天CRP、WBC、皮质醇水平比较,P均>0.05。对照组治疗第1天和第5天CRP、WBC、皮质醇水平比较,P均<0.05。观察组治疗第1天和第5天CRP、WBC、皮质醇水平比较,P均<0.05。两组治疗第5天CRP、WBC、皮质醇水平比较,P均<0.05。两组治疗第1天TNF-α、IL-6水平比较,P均>0.05。对照组治疗第1天和第5天TNF-α、IL-6水平比较,P均<0.05。观察组治疗第1天和第5天TNF-α、IL-6水平比较,P均<0.05。两组治疗第5天TNF-α、IL-6水平比较,P均<0.05。两组治疗后FEV、VC、FVC、FEVl、MVV比较,P均<0.05。结论胸腹腔镜食管癌根治术,手术创伤小、疼痛轻,有效减少肺功能损害,提高免疫功能和预后效果。

Objective To explore the effects of laparoscopic radical resection and open resection on the lung function,stress response and immune function of esophageal cancer patients.Methods Eighty patients with esophageal cancer were enrolled and divided into two groups according to surgical methods.40 patients in the control group were treated with open radical surgery of esophageal cancer.40 patients in the observation group were treated with laparoscopic radical resection of esophageal cancer.The lung function,stress response,immune function and other changes of the two groups were compared before and after treatment.Results At the first day of treatment,there were no significant differences in CRP,WBC and cortisol levels between the two groups(P>0.05).The levels of CRP,WBC and cortisol were compared with P<0.05 at the first day and fifth day of treatment.The levels of CRP,WBC and cortisol were compared with P<0.05 at the fifth day of treatment between the two groups.At the first day of treatment,there were no significant differences in TNF-αand IL-6 between the two groups(P>0.05).The levels of TNF-αand IL-6 were compared with P<0.05 at the first day and fifth day of treatment.The levels of TNF-αand IL-6 were compared with P<0.05 at the fifth day of treatment between the two groups.The levels of FEV、VC、FVC、FEVl and MVV were compared with P<0.05 after treatment between the two groups.Conclusion Laparoscopic radical resection of esophageal cancer with small trauma and less pain can effectively reduce the damage of lung function,improve the immune function and prognosis,which have significant therapeutic effect and important research value.