本文選題：胸腔鏡食管癌切除術(shù)　切入點：食管癌　出處：《中華醫(yī)院感染學(xué)雜志》2017年17期 　論文類型：期刊論文

【摘要】：目的探討胸腔鏡食管癌切除術(shù)對術(shù)后肺部感染和炎癥細胞因子的影響。方法選取2013年12月-2016年12月醫(yī)院收治的86例食管癌患者,采用數(shù)字表法隨機分為觀察組與對照組,每組43例;觀察組患者實施胸腔鏡食管癌切除術(shù),對照組患者實施傳統(tǒng)的開胸手術(shù),觀察兩組患者術(shù)后肺部感染情況,并分析不同手術(shù)方式對炎癥細胞因子的影響。結(jié)果經(jīng)不同手術(shù)治療后,兩組均無一例死亡病例,觀察組術(shù)后肺部感染率13.95%明顯少于對照組39.53%,差異有統(tǒng)計學(xué)意義(P0.05);觀察組患者術(shù)后2、24、72hC-反應(yīng)蛋白(CRP)(69.00±16.01、94.32±22.42、127.94±25.91)mg/L及白細胞計數(shù)(WBC)(11.26±2.76、14.78±3.81、8.01±2.11)×109/L及呼吸頻率(28.32±4.32、35.21±5.01、38.20±3.98)次/min均明顯低于對照組患者;觀察組患者術(shù)后1、2、24h及術(shù)后1周白細胞介素-6(IL-6)(372.12±30.21、413.27±35.48、287.03±17.88、77.45±18.21)ng/L、白細胞介素-8(IL-8)(379.43±37.32、402.87±33.07、297.69±20.17、81.23±20.87)ng/L、白細胞介素-10(IL-10)(281.65±35.33、290.87±37.01、301.21±38.00、160.32±30.87)ng/L均低于對照組,差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論食管癌患者行胸腔鏡食管癌切除術(shù),安全有效,術(shù)后肺部感染率低;術(shù)后CRP、IL等炎癥細胞因子水平明顯低于傳統(tǒng)手術(shù);目前胸腔鏡食管癌切除術(shù)僅適用于食管癌中早期及不耐受開胸手術(shù)的患者,為達到該術(shù)式的廣泛應(yīng)用,還需進一步研究。
[Abstract]:Objective to investigate the effect of thoracoscopic resection of esophageal carcinoma on pulmonary infection and inflammatory cytokines after operation. Methods 86 patients with esophageal cancer treated in our hospital from December 2013 to December 2016 were randomly divided into observation group and control group by digital table method. 43 patients in each group were treated with thoracoscopic resection of esophageal cancer, while patients in control group were treated with traditional thoracotomy, and pulmonary infection was observed after operation in both groups. The effects of different surgical methods on inflammatory cytokines were analyzed. The postoperative pulmonary infection rate in the observation group was significantly lower than that in the control group (P 0.05), the postoperative lung infection rate in the observation group was significantly lower than that in the control group (P 0.05), and the number of CRPs in the observation group was 69.00 鹵16.01 鹵16.01 鹵22.41 鹵127.94 鹵25.91 mg / L and the white blood cell count was 11.26 鹵2.76.78 鹵3.81 鹵8.01 鹵2.11) 脳 10 9 / L and the respiratory frequency was 28.32 鹵4.32 鹵5.112 鹵38.20 鹵3.98). In the observation group, the levels of IL-6T were 372.12 鹵30.21, 413.27 鹵35.48, 287.03 鹵17.88, 77.45 鹵18.21ngL, 379.43 鹵37.3402.87 鹵37.32402.87 鹵33.0297.69 鹵20.171.23 鹵20.87ngL, IL-101.65 鹵33290.87 鹵37.01301.21 鹵38.00 鹵160.32 鹵30.87ngL, respectively. Conclusion the patients with esophageal carcinoma are safe, effective and effective. The postoperative lung infection rate was low, the level of inflammatory cytokines such as CRPU IL was significantly lower than that of traditional surgery. At present, thoracoscopic resection of esophageal cancer is only suitable for patients with esophageal cancer in the early stage and intolerant of open thoracic surgery, in order to achieve the wide application of this procedure. Further study is needed.
【作者單位】： 海南醫(yī)學(xué)院第二附屬醫(yī)院胸外科;
【分類號】：R563.1;R735.1

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