胸腔镜微创根治术对食管癌患者创伤应激反应及预后的影响

Effect of Minimally Invasive Thoracoscopic Radical Mastectomy on Traumatic Stress Response and Prognosis of Patients with Esophageal Cancer

目的:探讨胸腔镜微创根治术对食管癌患者创伤应激反应及预后的影响。方法:选择2018年6月—2019年6月河南科技大学第二附属医院收治的食管癌患者113例作为研究对象,采用随机数表法的原则将其分为对照组(n=56)和观察组(n=57)。对照组行常规开放手术,观察组行胸腔镜微创根治术。比较分析两组手术各项指标、创伤应激反应[C反应蛋白(CRP)游离甲状腺素(FT4)]及预后。结果:与对照组相比,观察组手术时间长,术中失血量与补液量少,住院时间短,差异有统计学意义(P<0.05);两组术后WBC、CRP、FT4均降低,但观察组比对照组低,差异有统计学意义(P<0.05);观察组术后1年累计复发转移率略低于对照组,生存率略高于对照组,但差异无统计学意义(P>0.05)。结论:对食管癌患者行胸腔镜微创根治术疗效确切,可有效改善创伤应激反应,减少术中失血量及补液量,缩短住院时间,降低复发转移率。

Objective:To investigate the effect of thoracoscopic minimally invasive radical mastectomy on traumatic stress response and prognosis of patients with esophageal cancer.Methods:113 patients with esophageal cancer treated in the hospital from June 2018 to June 2019 were selected as the research objects,and they were divided into the control group(n=56)and the observation group(n=57)by the principle of random number table method.The control group underwent conventional open surgery,and the observation group underwent thoracoscopic minimally invasive radical surgery.V arious surgical indicators,traumatic stress response[C-reactive protein(CRP),free thyroxine(FT4)]and prognosis of the two groups were compared and analyzed.Results:Compared with the control group,the observation group had longer operation time,less intraoperative blood loss and fluid replacement,and shorter hospital stay,the difference was statistically significant(P<0.05).WBC,CRP,and FT4 decreased in the two groups after surgery,but the observation group was lower than the control group,and the difference was statistically significant(P<0.05).The cumulative recurrence and metastasis rate of the observation group 1 year after surgery was slightly lower than that of the control group,and the survival rate was slightly higher than the control group,the difference was not statistically significant(P>0.05).Conclusion:Minimally invasive thoracoscopic surgery for patients with esophageal cancer has a definite effect,which can effectively improve traumatic stress response,reduce intraoperative blood loss and fluid supplementation,shorten hospital stay,and reduce recurrence and metastasis rate.