【摘要】 目的探讨经左胸保留膈肌食管裂孔术式在食管癌手术中的应用效果。方法随机接受食管癌手术的68例患者分为2组,每组34例。观察组采用经左胸保留膈肌食管裂孔术式,对照组采用经左胸切开膈肌术式。比较2组手术效果。结果 2组手术时间、术中出血量及术后膈疝发生率差异无统计学意义（P>0.05）。观察组术后肺部感染率低于对照组;术后第7天及1个月的MVV%、FEVl%、FVC%及ΔPaO₂、ΔPaCO₂均优于对照组,差异有统计学意义（P<0.05）。术后3个月2组患者的MVV%、FEVl%、FVC%及ΔPaO₂、ΔPaCO₂差异均无统计学意义（P>0.05）。结论经左胸保留膈肌食管裂孔的食管癌手术,可有效改善患者术后近期的呼吸功能,减少术后肺部感染率。更多还原

【Abstract】 Objective To investigate the application of esophagectomy with diaphragm hiatal preservation in esophageal carcinoma patients. Methods Totally 68 esophageal carcinoma patients were divided into 2 groups,Each group 34 cases,observation group received esophagectomy with diaphragm hiatal and control group received esophagectomy. The pulmonary function and blood gas were measured on the 7th day,1st month and 3rd month after the operation. And the time of operation,the intra-operative bleeding,the cases of postoperative diaphragmatic hernia and pulmonary infection were also recorded respectively. Results There was no significant difference between the 2 groups in operation time,intraoperative blood loss and postoperative diaphragmatic hernia(P > 0. 05). The postoperative infection rate of the observation group was lower than that of the control group; The differences between the 2 groups in the pulmonary function(MVV% 、FEV1% 、FVC%),theΔPa O2 and ΔPa CO2 on 7th day and 1st month after the operation were significant(P < 0. 05). The differences between the 2 groups in the pulmonary function(MVV% 、FEV1% 、FVC%),the ΔPa O2 and ΔPa CO2 on 3rdmonth after the operation were not significant(P > 0. 05). The cases of postoperative pulmonary infection in the observation group were significantly less than that of control group(P < 0. 05). Conclusion The esophagectomy with diaphragm hiatal preservation can significantly improve the postoperative respiratory function during the perioperative period and reduce the postoperative pulmonary infection rate.更多还原