胸腹腔镜联合微创手术治疗食管癌患者的临床疗效及血清学相关标志物变化的影响分析

Comparative study on the clinical effects of thoracolaparoscopic surgery and open operation on serum indexes of esophageal cancer patients

目的:探讨联合胸腹腔镜微创治疗食管癌患者的临床疗效及血清学相关标志物的变化。方法:选取2014年12月至2017年6月收治的60例食管癌患者,将其随机分为治疗组和对照组,各30例。治疗组行胸腹腔镜微创手术,对照组行传统开胸手术,比较两组患者术后肺功能、VAS评分、围术期及血清学相关指标等。结果:术后1周治疗组肺功能及血气分析指标均显著高于对照组,同时VAS评分明显降低,均P<0.05。治疗组胸腔引流管留置时间及术后住院时间均短于对照组,且术中出血量及术后胸腔引流量均少于对照组,同时治疗组术后并发症发生率较低,均P<0.05。两组在淋巴结清扫数目及手术时间方面比较无差异(P>0.05)。术前1 d两组血清学过氧化及胃肠激素相关指标比较差异均无统计学意义(P>0.05);术后3 d两组血清GSH-Px、MTL及CCK水平均有所下降,其中治疗组下降程度显著低于对照组(P<0.05),两组血清MDA水平术后3 d有所升高,且对照组升高程度显著高于治疗组(P<0.05)。术前两组血清学指标比较差异均无统计学意义(P>0.05);术后1个月两组血清肿瘤预后标志物水平均有所下降,其中治疗组下降程度显著高于对照组(P<0.05)。结论:联合胸腹腔镜微创治疗食管癌能有效加快患者康复,提高患者短期预后,值得临床大力推广。

Objective： To explore the clinical effects of thoracolaparoscopic surgery and open operation on serum indexes of esophageal cancer patients. Methods： Sixty cases of patients with esophageal cancer admitted to our hospital from December 2014 to June 2017 were randomly divided into treatment group and control group,30 cases in each. The control group was treated with traditional open resection of esophageal carcinoma,while the treatment group was treated through the application of thoracic esophageal carcinoma combined with laparoscopy. The pulmonary function,VAS scores,perioperative and serum indicators were observed and compared between the two groups. Results： After treatment,the levels of pulmonary function indexes in the treatment group were better than those of control group,with statistical differences（ P〈0. 05）,and the VAS scores in the treatment group were lower than those of the control group（ P〈0. 05）. There was no significant difference in number of node dissection and the operation time between the two groups（ P〈0. 05）,but compared with the control group,the chest tube indwelling time,postoperative hospital stay,blood loss and the other indexes were significantly reduced in the treatment group（ P〈0. 05）. The levels of serum GSH-Px,MTL and CCK of the two groups decreased,and the levels in the control group were lower than those of the treatment group（ P〈0. 05）,while the levels of serum MDA of the two groups increased,and the levels in the control group were higher than those of the treatment group（ P〈0. 05）.And after treatment,the levels of serum endoglin and RCASl of the two groups decreased,but the levels in the treatment group were lower than those of the control group（ P〈0. 05）. Conclusion： The thoracolaparoscopic surgery can speed up the recovery and improve the short-term prognosis,thus should be widely applied.