经腹与经左胸贲门癌根治术治疗老年贲门癌的临床效果及对应激反应的影响

Clinical Effect of Transabdominal and Transleft Thoracotomy for Cardial Carcinoma in Elderly Patients and Its Influence on Stress Response

目的探究经腹与经左胸贲门癌根治术治疗老年贲门癌的临床效果及对应激反应的影响。方法选取2019年3月—2020年3月黄河科技学院附属医院收治的98例老年贲门癌患者为研究对象,运用随机数表法分为经左胸入路治疗组(经左胸组)和经腹入路治疗组(经腹组),各49例。比较两组患者手术指标、术后疼痛及应激反应情况、并发症发生率、术后1年生存率。结果经腹组手术时间、术后引流量、术中出血量、住院时间分别为(187.79±24.97)min、(299.97±89.97)mL、(65.89±9.15)mL和(11.13±2.98)d,均优于左胸组,差异有统计学意义(t=4.415、3.647、3.700、4.954,P均<0.05)。经腹组运动与静息时视觉模拟评分法评分均低于经左胸组,术后超氧化物歧化酶水平高于经左胸组,C反应蛋白和丙二醛水平低于经左胸组,差异有统计学意义(P均<0.05)。经腹组术后肺部并发症发生率为4.08%,低于经左胸组的16.33%,差异有统计学意义(χ^(2)=4.009,P<0.05);两组其他手术并发症和术后1年存活率对比,差异无统计学意义(P均>0.05)。结论经腹入路治疗可减轻老年贲门癌患者术后疼痛和氧化应激反应,减少并发症的发生。

Objective To explore the clinical effect of transabdominal and transleft thoracotomy for cardial carcinoma radical resection in the treatment of senile cardial carcinoma and its influence on stress response.Methods A total of 98 elderly patients with cardial cancer admitted to the Affiliated Hospital of Huanghe Science and Technology College from March 2019 to March 2020 were selected as the study objects and were divided into left thoracic approach group(left thoracic group)and abdominal approach group(transabdominal group)by random number table method,with 49 cases in each group.The indicators,postoperative pain and stress response,complication rate,and 1 year postoperative survival rate were compared between the two groups.Results The operative time,postoperative drainage volume,intraoperative blood loss and hospital stay of the transabdominal group were(187.79±24.97)min,(299.97±89.97)mL,(65.89±9.15)mL and(11.13±2.98)d,better than those in the left thoracic group,and the differences were statistically significant(t=4.415,3.647,3.700,4.954,all P<0.05).The Visual Analogue Scale scores at exercise and rest in the transabdominal group were lower than those in the left thoracic group,the level of superoxide dimutase of transabdominal group was higher and level of C-reactive protein and malondialdehyde were lower,and the differences were statistically significant(all P<0.05).The incidence of postoperative pulmonary complications in the transabdominal group was 4.08%,which was lower than 16.33%in the left thoracic group,and the difference was statistically significant(χ^(2)=4.009,P<0.05).There was no statistically significant difference in other complications and 1 year survival rate between the two groups(all P>0.05).Conclusion Transabdominal approach can reduce postoperative pain and oxidative stress response and reduce the occurrence of complications.