【摘要】 目的探讨胸、腹腔镜联合手术与常规开胸手术治疗食管癌的临床效果。方法选取2014年7月～2019年4月我院收治的200例食管癌患者作为研究对象,按照随机数字表法分为对照组(100例)与观察组(100例)。对照组患者采用常规开胸手术的方法,观察组患者采用胸腔镜+腹腔镜联合手术的方法。比较两组患者的手术用时、术中出血量、淋巴结清扫数量、胸腔引流量、术后拔管耗时、住院时间、肺功能指标及并发症发生情况。结果两组患者的手术用时、术中出血量比较,差异无统计学意义(P>0.05);观察组患者的淋巴结清扫数量多于对照组,差异有统计学意义(P<0.05);观察组患者的胸腔引流量少于对照组,差异有统计学意义(P<0.05);观察组患者的术后拔管耗时、住院时间短于对照组,差异有统计学意义(P<0.05);观察组患者的肺活量(VC)、最大通气量(MVV)、第1秒用力呼气容积(FEV1)均高于对照组,差异有统计学意义(P<0.05);观察组患者的并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论胸、腹腔镜联合手术治疗食管癌的临床效果显著,手术完成较为理想,可以恢复肺功能,且术后并发症较少,值得临床推广应用。更多还原

【Abstract】 Objective To explore the clinical effect of combined thoracic and laparoscopic surgery and conventional thoracotomy in the treatment of esophageal cancer. Methods A total of 200 patients with esophageal cancer treated in our hospital from July 2014 to April 2019 were selected as the research objects. They were divided into control group(100 cases) and observation group(100 cases) according to the random number table method. The patients in the control group were operated by conventional thoracotomy, while the patients in the observation group were operated by thoracoscopy combined with laparoscopy. The operative time, intraoperative blood loss, number of lymph node dissection,thoracic drainage, postoperative extubation time, hospitalization time, pulmonary function indicators and complications of the two groups were compared. Results There was no statistically significant difference in operative time and intraoperative blood loss between the two groups(P>0.05). The number of lymph node dissection in the observation group was more than that in the control group, and the difference was statistically significant(P<0.05). The thoracic drainage volume in the observation group was less than that in the control group, and the difference was statistically significant(P <0.05). The time of extubation and hospitalization in the observation group were shorter than those in the control group, with statistically significant differences(P<0.05). The vital capacity(VC), maximal voluntary ventilation(MVV)and forced expiratory volume in one second(FEV1) in the observation group were higher than those in the control group,with statistically significant differences(P<0.05). The total incidence of complications in the observation group was lower than that in the control group, and the difference was statistically significant(P<0.05). Conclusion The clinical effect of thoracic and laparoscopic surgery has an significant effect on patients with esophageal cancer, with ideal completion of surgery, which can recover lung function, and has less postoperative complications, it is worthy of clinical application.更多还原