改良Ivor-Lewis术式与Mckeown术治疗食管癌的效果及对肺功能、炎症指标的影响

Effect of modified Ivor-Lewis operation and Mckeown operation in the treatment of esophageal cancer and its influence on lung function and inflammatory indexes

目的探讨改良Ivor-Lewis术式与Mckeown术治疗食管癌的效果及对肺功能、炎症指标的影响。方法选择2017年3月至2021年2月安徽省淮北矿工总医院接诊的80例食管癌患者,采用随机数字表法分为A组和B组,各40例。A组使用改良Ivor-Lewis术式治疗,B组使用Mckeown术治疗。比较两组围手术期指标、用力肺活量(FVC)、第1秒用力呼气容积/FVC(FEV1/FVC)、降钙素原(PCT)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)的变化和术后并发症发生率。结果A组手术时间、住院时间短于B组,术中出血量少于B组(P<0.05)。A组FVC、FEV1/FVC高于B组,血清PCT、CRP、TNF-α水平低于B组(P<0.05)。A组并发症总发生率低于B组(P<0.05)。结论与Mckeown术比较,改良Ivor-Lewis术式对食管癌患者肺功能、炎症指标的影响更小。

Objective To study the effect of modified Ivor Lewis operation and Mckeown operation in the treatment of esophageal cancer and its influence on lung function and inflammatory indexes.Methods A total of 80 patients with esophageal cancer treated in Huaibei Coal Miners General Hospital of Anhui Province from March 2017 to February 2021 were selected and they were divided into group A and group B by random number table method,with 40 patients in each group.Group A was treated with modified Ivor-Lewis and group B was treated with Mckeown.The changes of perioperative indexes,forced vital capacity(FVC),forced expiratory volume per second/FVC(FEV1/FVC),procalcitonin(PCT),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),and the incidence of postoperative complications were compared between the two groups.Results The operative time and hospital stay of group A were shorter than that of group B,and the amount of intraoperative blood loss was less than that of group B(P<0.05).The levels of FVC,FEV1/FVC in group A were higher than those in group B,and the levels of PCT,CRP and TNF-αin serum were lower than those in group B(P<0.05).The total incidence of complications in group A was lower than that in group B(P<0.05).Conclusion Compared with Mckeown surgery,the modified Ivor-Lewis surgery have less impact on lung function and inflammatory indexes in patients with esophageal cancer.