胸腔镜下食管癌手术对术后早期肺功能影响的临床研究

Clinical research on influences of early-stage pulmonary function after esophageal cancer operation under thoracoscope

目的研究胸腔镜下食管癌手术对术后早期肺功能的影响。方法随机选取本院2010年3月-2013年3月收治的20例食管癌患者,并随机分为对照组（8例）和观察组（12例）,其中对照组实施常规开胸手术治疗,观察组实行胸腔镜下手术,统计记录两组的出血量、手术时间、引流时间、疼痛评分、肺功能情况及术后并发症情况。结果观察组出血量少于对照组,手术时间、引流时间短于对照组,术后麻醉失效后疼痛评分明显低于对照组,差异有统计学意义（P〈0.05）;术后观察组患者肺部影响和并发症发生率明显低于对照组,差异有统计学意义（P〈0.05）。结论胸腔镜下手术早期对肺功能具有一定影响,但随着治疗进程,影响慢慢减小,且相比于常规开胸手术的影响要小,值得在临床适应证上推广实行。

Objective To study the influence of early-stage pulmonary function after esophageal cancer operation under thoracoscope. Methods From March 2010 to March 2013,20 patients with esophageal cancer in our hospital were randomly selected and divided into control group（n=8） and observation group（n=12）.In the control group,patients were treated by conventional thoracotomy,while in the observation group,patients were operated under thoracoscope.Amount of bleeding during treatment,operation time,drainage time,postoperative pain score,and postoperative influence on pulmonary function in the two groups was statistically recorded. Results The amount of bleeding in observation group was less than that of control group,operation time and drainage time was shorter than that of control group,and postoperative pain score was lower than that of control group,the difference was significant（P〈0.05）.In the observation group,the postoperative influence on pulmonary function and incidence of postoperative complications was lower than that in the control group,the difference was significant（P〈0.05）. Conclusion Surgery under thoracoscope at an early stage has some influence on pulmonary function,but with the process of treatment,the influence gradually decreases.Compared with the influence by conventional thoracotomy,the influence under thoracoscope is milder,which is worthy of application and expansion for appropriate clinical indications.