胸腹腔镜与传统开胸手术对食管癌患者术后炎症因子的影响

发布时间：2018-02-02 06:35

本文关键词： 胸腹腔镜手术开胸手术食管肿瘤细胞因子炎症反应　出处：《第三军医大学学报》2017年23期 　论文类型：期刊论文

【摘要】：目的对比研究胸腹腔镜手术(minimally invasive esphagectomy,MIE)与传统开胸手术(open esophagectomy,OE)食管癌患者术后炎症因子水平的变化,探讨两种手术方法引起炎性反应的差异。方法选取2015年11月至2016年3月重庆医科大学附属第一医院胸心外科符合研究标准的食管癌患者共28例(MIE组及OE组各14例),采集患者术前和术后6、12、24、48 h血液样本。采用ELISA测定血清细胞因子内皮素(endothelin,ET)、白细胞介素-8(interleukin-8,IL-8)、白细胞介素-10(IL-10)及肿瘤坏死因子α(tumour necrosis factorα,TNF-α)水平。结果 OE组中位年龄为67.5岁,MIE组中位年龄为61岁,两组患者一般资料及手术时间差异无统计学意义(P0.05)。与OE组比较,MIE组术中出血量、术后入ICU时间、术后留院时间及肺部感染例数差异均有统计学意义(P0.05)。术后第6、12、24小时血清IL-8水平,术后第6、12小时血清TNF-α水平,术后各时间点血清IL-10水平差异均有统计学意义(P0.05)。结论与传统开胸手术比较,胸腹腔镜手术治疗食管癌引起的炎症反应程度相对较轻,更有利于患者术后恢复。
[Abstract]:Objective to compare and study minimally invasive esphagectomy in thoracic laparoscopic surgery. The changes of inflammatory factors in patients with esophageal carcinoma after operation of mie) and open esophagectomy (OEE). Methods from November 2015 to March 2016, 28 patients with esophageal cancer in the first affiliated Hospital of Chongqing Medical University were selected. (. There were 14 cases in MIE group and 14 cases in OE group. Blood samples were collected from the patients before and after operation for 48 hours. Serum endothelin et was measured by ELISA. Interleukin-8 (IL-8). Interleukin-10 (IL-10) and tumor necrosis factor 伪 (TNF- 伪) tumour necrosis factor 伪. Results the median age of OE group was 67.5 years old and the median age of mie group was 61 years old. There was no significant difference in general data and operation time between the two groups (P 0.05). Compared with OE group, the volume of intraoperative bleeding and the time of entering ICU after operation in mie group were higher than those in OE group. There were significant differences in the length of stay in hospital and the number of patients with pulmonary infection after operation (P 0.05). The serum IL-8 level was 1224 hours after operation, and the level of TNF- 伪 was 12 hours after operation. There were significant differences in serum IL-10 levels at different time points after operation (P 0.05). Conclusion compared with traditional thoracotomy, the degree of inflammatory reaction caused by thoracic laparoscopic surgery for esophageal cancer is relatively mild. More conducive to postoperative recovery of patients.
【作者单位】：重庆医科大学附属第一医院胸心外科;重庆市人民医院胸外科;
【基金】：重庆市卫生局医学科研面上项目(20132110)~~
【分类号】：R735.1
【正文快照】： 食管癌是我国常见的癌症,其发病率及病死率分入本研究的患者均签署知情同意书。别为第6位及第4位[1]。手术是其主要治疗方式,目最终纳入住院患者共28例,男性22例,女性8前主要有传统开胸食管癌根治术与微创食管癌根治术例;OE组中位年龄67.5(50~78)岁,MIE组中位年龄两种手术方式

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