McKeown食管癌根治术管状胃对患者肺功能的影响

Effect of the gastric tube on pulmonary function after Mc Keown esophagectomy

目的回顾分析Mc Keown食管癌根治术管状胃法对术后呼吸功能的影响。方法选择2011年7月~2014年6月在我院行Mc Keown食管癌根治术患者80例,并随机分为观察组和对照组各40例,观察组术中行管状胃法,对照组术中行全胃法。测定术前1周内、术后第4周肺功能,测定术前3日内、术后第3日动脉血气分析。结果两组患者术后Pa O2均较术前下降,术后观察组Pa O2高于对照组,差异有统计学意义（P〈0.05）;两组Pa CO2较术前略有升高,术后观察组Pa CO2略低于对照组,但差异无统计学意义（P〉0.05）。术后两组患者FEV1%,VC%,MVV%,FVC%均较术前不同程度下降,术后观察组FEV1%,VC%,FVC%高于对照组,差异有显著性（P〈0.05）。术后观察组MVV%高于对照组,但差异无统计学意义（P〉0.05）。结论管状胃法相比全胃法在术后早期及晚期影响肺功能较小。

Objective To retrospective analyse the effect of the gastric tube on respiratory function after Mc Keown esophagectomy. Methods 80 patients with gastric tube from July 2011 to June 2014 were randomly divided into observation group（40 cases） and control group（40 cases）,patients in control group were treated with conventional esophagectomy,while others were treated with Mc Keown esophagectomy.After the treatment,the lung function and arterial blood gas of patients in both groups were observed. Results After the treatment,the Pa O2 level of patients in both groups were significantly decreased（P〈0.05）,while the level Pa O2 of patients in observation group was higher than those in control group（P〈0.05）.After the treatment,the Pa CO2 level of patients in both groups were slightly increased,while the level Pa CO2 of patients in observation group was slight lower than those in control group,but there was no significant difference（P〈0.05）.After the treatment,the levels of FEV1%,VC%,MVV%,FVC% of all patients significantly decreased（P〈0.05）.The levels of FEV1%,VC%,FVC% of patients in observation group were higher than those in control group（P〈0.05）, while there was no significant difference on the MVV% level between two group（P〈0.05）. Conclusion Compared with conventional esophagectomy,the treatment of Mc Keown esophagectomy for patients with gastric tube has a smaller effect of tubular stomach lung function, and it is worth for clinical promotion.