胸胃对食管癌围术期呼吸功能的影响

Effects of the thoracic stomach respiratory function after esophagectomy for esophageal cancer

探讨胸胃对食管癌围术期呼吸功能的影响。方法 自 1997年 7月至 1998年 4月 ,连续选择食管癌病人 36例 ,其中行食管癌切除食管胃主动脉弓上吻合 18例 ,弓下吻合 18例。动态监测围术期肺功能及血气分析主要指标变化。结果 弓上吻合较弓下吻合对PaO2 的影响差异始终有显著性 (P <0 0 5) ,手术第 10d以后对VC %、FVC %、MVV %的影响差异显著 (P <0 0 5) ,对FEV1 0 %的影响差异始终无显著性 (P >0 .0 5) ;弓上吻合较弓下吻合引起肺部感染与心律失常的相对危险度为 2 5。结论 食管癌切除术后 。

Objective: To detect the effects of the thoracic stomach on respiratory function after esophagectomy for esophageal carcinoma. Method: From July 1997 to April 1998, 36 patients with esophageal carcinoma underwent esophagectomy. The site of esophagogastric anastomosis was above aortic arch in 18 patients and Below aortic arch was in 18.Patients were monitored from the 3rd preoperative day to the 14th postoperative day for respiratory function and blood gas analysis. Result There was a significant difference in PaO 2 between the esophagogastric anastomosis above and below the aortic arch. The differences in VC%,FVE% and MVV% occurred only after 10th postoperative days. While FEV 1.0 % had no significant difference from beginning to end (P>0.05). Conclusion: After esophagectomy, esophagogastric anastomosis above aortic arch has significant negative effect on respiratory function.