改良Ivor-Lewis术治疗食管癌的短期随访研究

Short term follow-up study of modified Ivor Lewis procedure for esophageal cancer

目的分析改良Ivor-Lewis术治疗食管癌患者的效果。方法选取洛阳中心医院2017年4月至2020年7月收治的88例食管癌患者,依照随机数字表法将其分为两组,每组44例。对照组接受传统Ivor-Lewis术,观察组接受改良Ivor-Lewis术,比较两组手术相关(手术时长、淋巴结清扫数量、术中失血量)、术后恢复情况(戴鼻胃管时间、住院时间)、术前及术后1个月肺功能[肺活量(FVC)、最大呼气中期流速(MMF)、每分钟最大通气量(MVV)]、术前及术后7 d炎性因子水平[血清干扰素γ(IFN-γ)、白细胞介素(IL)-6、超敏C反应蛋白(hs-CRP)]。结果观察组手术时长、戴鼻胃管时间、住院时间较对照组短,淋巴结清扫数量较对照组多,术中失血量较对照组少(P<0.05)。术后1个月,观察组FVC、MMF、MVV均较对照组高(P<0.05)。术后7 d,与对照组比较,观察组血清IFN-γ、IL-6、hs-CRP较低(P<0.05)。结论食管癌患者接受改良Ivor-Lewis术治疗,能优化手术相关指标,促进术后恢复,且对肺功能、炎性因子水平影响小。

Objective To analyze the effect of modified Ivor Lewis procedure on esophageal cancer.Methods From April 2017 to July 2020,88 patients with esophageal cancer in Luoyang Central Hospital were randomly divided into two groups,with 44 cases in each group.The control group was treated with traditional Ivor Lewis operation,and the observation group was treated with modified Ivor Lewis operation.The operation related(operation time,number of lymph node dissection,intraoperative blood loss),postoperative recovery(time of wearing nasogastric tube,length of hospital stay),lung function(FVC,MMF,MVV)before and 1 month after operation were compared between the two groups were compared.The levels of inflammatory factors(serum IFN-γ,IL-6,hs CRP)were measured before and 7 days after operation.Results The operation time,time of wearing nasogastric tube and hospital stay of the observation group were shorter than those of the control group,the number of lymph node dissection was more than that of the control group,and the intraoperative blood loss was less than that of the control group(P<0.05).One month after operation,the levels of FVC,MMF and MVV of the observation group were higher than those of the control group(P<0.05).Seven days after operation,compared with the control group,the serum IFN-γ,IL-6 and hsCRP of the observation group were lower(P<0.05).Conclusions Modified Ivor Lewis operation can optimize the operation related indicators,promote postoperative recovery,and has little effect on lung function and inflammatory factors.