食管癌患者行胸腔镜切除术后对肺部感染和炎症细胞因子的影响

发布时间：2018-03-15 07:18

本文选题：胸腔镜食管癌切除术　切入点：食管癌　出处：《中华医院感染学杂志》2017年17期 　论文类型：期刊论文

【摘要】：目的探讨胸腔镜食管癌切除术对术后肺部感染和炎症细胞因子的影响。方法选取2013年12月-2016年12月医院收治的86例食管癌患者,采用数字表法随机分为观察组与对照组,每组43例;观察组患者实施胸腔镜食管癌切除术,对照组患者实施传统的开胸手术,观察两组患者术后肺部感染情况,并分析不同手术方式对炎症细胞因子的影响。结果经不同手术治疗后,两组均无一例死亡病例,观察组术后肺部感染率13.95%明显少于对照组39.53%,差异有统计学意义(P0.05);观察组患者术后2、24、72hC-反应蛋白(CRP)(69.00±16.01、94.32±22.42、127.94±25.91)mg/L及白细胞计数(WBC)(11.26±2.76、14.78±3.81、8.01±2.11)×109/L及呼吸频率(28.32±4.32、35.21±5.01、38.20±3.98)次/min均明显低于对照组患者;观察组患者术后1、2、24h及术后1周白细胞介素-6(IL-6)(372.12±30.21、413.27±35.48、287.03±17.88、77.45±18.21)ng/L、白细胞介素-8(IL-8)(379.43±37.32、402.87±33.07、297.69±20.17、81.23±20.87)ng/L、白细胞介素-10(IL-10)(281.65±35.33、290.87±37.01、301.21±38.00、160.32±30.87)ng/L均低于对照组,差异有统计学意义(P0.05)。结论食管癌患者行胸腔镜食管癌切除术,安全有效,术后肺部感染率低;术后CRP、IL等炎症细胞因子水平明显低于传统手术;目前胸腔镜食管癌切除术仅适用于食管癌中早期及不耐受开胸手术的患者,为达到该术式的广泛应用,还需进一步研究。
[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 卤16.01 卤16.01 卤22.41 卤127.94 卤25.91 mg / L and the white blood cell count was 11.26 卤2.76.78 卤3.81 卤8.01 卤2.11) 脳 10 9 / L and the respiratory frequency was 28.32 卤4.32 卤5.112 卤38.20 卤3.98). In the observation group, the levels of IL-6T were 372.12 卤30.21, 413.27 卤35.48, 287.03 卤17.88, 77.45 卤18.21ngL, 379.43 卤37.3402.87 卤37.32402.87 卤33.0297.69 卤20.171.23 卤20.87ngL, IL-101.65 卤33290.87 卤37.01301.21 卤38.00 卤160.32 卤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.
【作者单位】：海南医学院第二附属医院胸外科;
【分类号】：R563.1;R735.1

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