术前口服橄榄油标记胸导管预防食管癌术后乳糜胸的效果分析

Effect Analysis of Preoperative Oral Olive Oil Labeling of Thoracic Duct on Preventing Chylothorax After Esophageal Cancer Surgery

目的:探讨术前口服橄榄油标记胸导管预防食管癌术后乳糜胸的效果。方法:选取2019年11月—2021年11月于湖北省麻城市人民医院行胸腔镜下食管癌根治术的100例食管癌患者作为研究对象,随机分为标记组与未标记组,各50例。标记组术前6~8 h口服橄榄油标记胸导管,未标记组给予常规术前准备。比较两组不良事件发生情况、围术期指标、炎性因子水平。结果:标记组胸导管暴露率高于未标记组,胸导管损伤率低于未标记组,差异有统计学意义(P<0.05);两组术后乳糜胸发生率、二次手术结扎胸导管发生率比较,差异无统计学意义(P>0.05)。两组术后引流量、术后住院时间比较,差异无统计学意义(P>0.05);标记组术后拔管时间短于未标记组,差异有统计学意义(P<0.001)。手术后,两组血清肿瘤坏死因子-α、白细胞介素-6水平均低于手术前,且标记组低于未标记组(P<0.05);两组血清C反应蛋白水平均高于手术前,但标记组低于未标记组,差异有统计学意义(P<0.05)。结论:术前口服橄榄油标记胸导管预防食管癌术后乳糜胸的效果显著,能够更好地暴露胸导管,降低术后乳糜胸的发生率,缩短术后拔管时间,减轻炎性反应。

Objective:To investigate the effect of preoperative oral olive oil labeling of thoracic duct on preventing chylothorax after esophageal cancer surgery.Methods:A total of 100 patients with esophageal cancer who underwent thoracoscopic radical resection of esophageal cancer in the People's Hospital of Macheng City of Hubei Province from November 2019 to November 2021 were selected as the study subjects.They were randomly divided into labeling group and non-labeling group,with 50 cases in each group.The labeling group implemented oral olive oil labeling of thoracic duct at preoperative 6-8 h.The non-labeling group was given conventional preoperative preparation.The occurrence of adverse events,perioperative indexes,and inflammatory factor levels were compared between the two groups.Results:The exposure rate of thoracic duct in the labeling group was higher than that in the non-labeling group,and the injury rate of thoracic duct in the labeling group was lower than that in the non-labeling group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of postoperative chylothorax and the incidence of secondary surgery for ligation of thoracic duct between the two groups(P>0.05).There was no significant difference in postoperative drainage volume and postoperative hospital stay between the two groups(P>0.05).The postoperative extubation time in the labeling group was shorter than that in the non-labeling group,and the difference was statistically significant(P<0.001).After surgery,serum tumor necrosis factor-αand interleukin-6 levels in two groups were lower than those before surgery,and the labeling group was lower than the non-labeling group(P<0.05);serum C-reactive protein levels in two groups were higher than those before surgery,but the labeling group was lower than the non-labeling group,and the difference was statistically significant(P<0.05).Conclusion:Preoperative oral olive oil labeling of thoracic duct is effective in preventing the chylothorax after esophageal cancer surgery,and can better expose the thoracic duct,reduce the incidence of postoperative chylothorax,shorten the time of postoperative extubation,and relieve inflammatory reaction.