胸腔镜联合超声内镜治疗食管平滑肌瘤的临床疗效及对患者血清炎性因子的影响

Clinically therapeutic effect of thoracoscopy combined with EUS in treating esophageal leiomyoma and its influence on serum inflammatory factors of patients

目的:探讨电视胸腔镜(VATS)联合超声内镜(EUS)对食管平滑肌瘤的治疗效果,以及对于患者血清炎性因子的影响。方法:选取200例接受手术治疗的食管平滑肌瘤患者,根据手术方式的不同将其分为观察组和对照组,每组100例。观察组采取VATS联合EUS治疗,对照组采取传统VATS手术治疗,分析两组患者术中及术后切口范围、出血量、手术时长以及住院时长。分别于术前及术后1 d、3 d检测两组患者的血清C-反应蛋白(CRP)、白细胞介素6(IL-6)、白细胞介素8(IL-8)、白细胞介素10(IL-10)及肿瘤坏死因子α(TNF-α)水平,比较两组的疗效及炎性因子水平。结果:观察组患者的切口范围及出血量与对照组相比明显减少,差异有统计学意义(t=13.333,t=21.259;P<0.05);手术时长及住院时长明显少于对照组,差异有统计学意义(t=21.739,t=9.005;P<0.05)。两组患者术后1 d和3 d的CRP、IL-6、IL-8、IL-10以及TNF-α水平均明显升高,且观察组明显低于对照组,差异有统计学意义[1 d(t=15.737,t=28.227,t=32.311,t=7.433,t=32.032;P<0.05)和3 d(t=25.289,t=19.269,t=10.983,t=10.946,t=4.398;P<0.05)]。结论:VATS联合EUS治疗食管平滑肌瘤相比传统VATS手术切口小、出血量少且手术时间短,并可减轻患者的炎性反应,加快患者术后恢复。

Objective: To investigate the therapeutic effect of video-assisted thoracic surgery(VATS) combined with endoscopic ultrasound(EUS) in treating esophageal leiomyoma and its influence on serum inflammatory factors of patients. Methods: A total of 200 patients with esophagus leiomyoma who received surgical treatment were enrolled in this study. And all of them were divided into observation group(100 cases) and control group(100 cases), The patients of observation group received combined treatment of VATS and EUS, and those of control group adopted traditionally surgical treatment of VATS. And the intraoperative and postoperative incision range, bleeding volume, operation duration and hospitalization duration between two groups were compared. The serum C-reaction protein, interleukin-6(IL-6), interleukin-8(IL-8), interleukin-10(IL-10) and tumor necrosis factor α(TNF-α) pre operation and at 1 d,3 d post operation were detected, respectively. And the therapeutic effect and the levels of inflammatory factors were further compared. Results: The incision range and bleeding volume of observation group were significantly less than those of control group(t=13.333, t=21.259, P<0.05). And the operation duration and hospitalization duration of observation group were significantly lower than those of control group(t=21.739, t=9.005, P<0.05). And the CRP, IL-6, IL-8, IL-10 and TNF-α of two groups at 1 d and 3 d post operation were obviously increased, and these indicators of observation group were significantly lower than those of control group [1 d(t=15.737, t=28.227, t=32.311, t=7.433, t=32.032, P<0.05), 3 d(t=25.289, t=19.269, t=10.983, t=10.946, t=4.398, P<0.05)]. Conclusion: Compared with traditional VATS, VATS combined with EUS has smaller incision, less bleeding volume and shorter operation time. And it can also alleviate the inflammatory reaction of patients and accelerate the recovery of patients post operation.