胸腔镜食管癌根治术与开放食管癌根治术后患者围手术期并发症发生率及机体创伤应激反应程度比较

摘要

Objective To compare the incidence of perioperative complications and the degree of traumatic stress reaction between thoracoscopic radical esophagectomy and open radical esophagectomy for esophageal cancer.Methods 97 patients with esophageal cancer in our hospital were divided into group A (thoracoscopic esophagectomy,n =51) and group B (open esophagectomy,n =46) according to the operation method.The group A was given thoracoscopic radical resection of esophageal cancer,while the group B was given open radical resection of esophageal cancer.The operative indexes (intraoperative blood loss,intraoperative fluid volume,operative time,incision length),the incidence rate of perioperative complications,body traumatic stress response indexes [white blood cell count (WBC),serum C-reactive protein (CRP),free thyroxine (FT4)] and tumor markers [squamous cell carcinoma antigen (SCC),carbohydrate antigen 125 (CA125)] were compared between the two groups.Results The group A had less intraoperative blood loss,intraoperative fluid volume and shorter operative time and incision length compare with group B (P ≤ 0.05).The incidence rate of perioperative complications in group A was lower than that in group B (17.65％ vs 36.96％) (P ≤ 0.05).There was no significant difference in the levels of WBC,CRP and FT4 between the two groups at the same time (P ＞ 0.05),so as the levels of SCC and CA125 (P ＞ 0.05).Conclusions Compared with open radical esophagectomy,the thoracoscopic esophagectomy had lower incidence of perioperative complications,but there was no significant difference in the degree of traumatic stress reaction between the two methods.%目的 比较胸腔镜食管癌根治术与开放食管癌根治术后患者围手术期并发症发生率及机体创伤应激反应程度.方法 将本院收治的97例食管癌患者作为研究对象,根据术式将其分为A组(胸腔镜食管癌根治术,n=51)和B组(开放食管癌根治术,n=46),比较两组患者手术指标(术中出血量、术中补液量、手术时间、手术切口长度),围手术期并发症发生率,机体创伤应激反应指标[白细胞计数(WBC)、血清C反应蛋白(CrRP)、游离甲状腺素(FT4)]水平,肿瘤标记物指标[鳞状细胞癌抗原(SCC)、糖蛋白抗原125(CA125)]水平.结果 A组术中出血量、术中补液量均少于B组(P≤0.05),手术时间和手术切口长度均短于B组(P≤0.05);A组围手术期并发症发生率17.65％低于B组的36.96％ (P ≤0.05);同一时间段,两组WBC、CRP和FT4水平差异无统计学意义(P＞0.05).同一时间段,两组SCC、CA125水平差异无统计学意义(P＞0.05).结论 胸腔镜食管癌根治术后患者围手术期并发症发生率低于开放食管癌根治术,两种术式术后患者机体创伤应激反应程度无明显差异.