36例胸腹腔镜联合食管癌根治术术后疗效分析

发布时间：2018-04-02 14:27

本文选题：食管肿瘤　切入点：胸腔镜　出处：《重庆医学》2017年01期

【摘要】：目的分析胸腹腔镜联合食管癌根治术与开放手术对围术期效果和术后生活质量的影响。方法收集2012年10月至2015年6月该科收治的74例食管癌患者资料,根据手术方式不同分为腔镜组36例和开放组38例。分析两种术式的围术期效果及并发症,并应用生活质量核心量表(EORTC QLQ-C30)和食管癌补充量表(EORTC QLQ-OES18)中文版问卷调查对比分析。结果腔镜组术中出血量,术后带管及住院时间,术后肺炎、胸腔积液和胃排空障碍等并发症发生率均较开放组低,手术时间较开放组长,差异均有统计学意义(P0.05)。术后1周、12周时两组患者的总健康状况和功能评分均下降,症状评分均升高,术后24周时两组患者各项评分均恢复至接近术前水平。腔镜组术后1周和12周在总体健康状况、躯体、角色、社会功能及疲倦、疼痛、呼吸困难、咳嗽困难症状方面评分优于开放组,其中总体健康状况、躯体功能及疲倦症状评分术后24周仍优于开放组,差异均有统计学意义(P0.05)。结论胸腹腔镜联合食管癌根治术在术中出血、带管、住院时间,以及术后一些并发症及术后生活质量评分方面具有相对优势,但手术时间更长。
[Abstract]:Objective to analyze the effect of thoracic laparoscopy combined with radical resection and open operation on perioperative effect and quality of life (QOL).Methods from October 2012 to June 2015, 74 patients with esophageal cancer were collected and divided into endoscopic group (n = 36) and open group (n = 38).The perioperative effects and complications of the two operations were analyzed, and a comparative analysis was made between the core quality of life scale (EORTC QLQ-C30) and the esophageal cancer supplement scale (EORTC QLQ-OES18).Results the incidence of complications such as intraoperative bleeding, postoperative tube and hospital stay, postoperative pneumonia, pleural effusion and gastric emptying disorder in the endoscopic group were lower than those in the open group, and the operative time was longer than that in the open group. The difference was statistically significant (P 0.05).At 1 week and 12 weeks after operation, the total health status and function scores of the two groups decreased, and the symptom scores increased. At 24 weeks after operation, the scores of the two groups recovered to close to the preoperative level.The scores of general health, body, role, social function and fatigue, pain, dyspnea, cough difficulty in the endoscopic group were better than those in the open group 1 and 12 weeks after operation.The scores of somatic function and fatigue symptom were still better than that of open group 24 weeks after operation, and the difference was statistically significant (P 0.05).Conclusion Thoracoscopy combined with radical resection of esophageal carcinoma has a comparative advantage in bleeding, tubing, hospital stay, postoperative complications and quality of life score, but the operative time is longer.
【作者单位】：中国医科大学附属盛京医院胸外科;
【分类号】：R735.1

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