目的：探讨右前外开胸加上腹正中切口与左后外切口开胸食管癌根治术对肺功能的影响，为临床食管癌手术治疗提供参考。方法选取2013年1月至2014年6月择期开胸食管癌根治术患者122例，随机分为对照组（n=61）和观察组（n=61）；对照组采用左后外侧切口行食管癌根治术治疗，观察组采用右前外侧开胸加上腹正中切口行食管癌根治术治疗；比较两组手术一般情况及手术前后肺功能情况。结果两组患者手术时间比较，差异无统计学意义（P>0.05）；观察组术中单肺通气时间、胸腔开放时间均显著短于对照组，差异有统计学意义（P<0.05）；两组患者手术后肺功能肺活量（VC）、最大通气量（MVV）、用力肺活量（FVC）、第一次用力肺活量（FEV1）指标显著低于手术前，差异有统计学意义（P<0.05）；对照组手术后肺功能VC、MVV、FVC、FEV1指标显著低于观察组手术后，差异有统计学意义（P<0.05）。结论食管癌根治术两种不同的手术途径均对患者肺功能造成一定的损伤，经右前外侧开胸加上腹正中切口手术对患者肺功能的损伤显著低于经左后外侧切口开胸手术，且能显著缩短术中单肺通气时间及胸腔开放时间。%ObjectiveTo investigate the rear right anterolateral thoracotomy and upper middle incision thoracotomy and resection of effect on lung function in thoracic esophageal carcinoma,to provide the reference for the clinical treatment of esophageal cancer operation.MethodsFrom January 2013 ~ June 2014 to our hospital for elective thoracic esophageal carcinoma patients after radical surgery in 122 cases,in accordance with the random number table method were randomly divided into control group(n=61)and treatment group(n=61); group was left after surgery for the treatment of esophageal cancer radical posterior incision group,treatment group with a right anterolateral thoracotomy and upper abdominal median incision for radical resection of esophageal cancer treatment; lung function were compared between the two groups before and after the general operation and operation.Resultscompared two groups of patients with operation time,no significant difference(P>0.05); treatment group during one lung ventilation time,pleural cavity open time was significantly shorter than that in the control group,and the difference was statistically significant (P<0.05); vital capacity of lung function in two groups of patients after operation(VC),maximal ventilatory volume(MVV),forced vital capacity(FVC),the first second forced vital capacity(FEV1)were significantly higher than that before the operation,and the difference was statistically significant(P<0.05); control group of pulmonary function after operation VC,MVV,FVC,FEV1 were significantly lower than the treatment group after the operation,and the difference is statistically significant(P<0.05).Conclusionall cause some damage on the pulmonary function of two different operation ways of esophageal cancer,through right anterolateral thoracotomy and abdominal median incision operation on pulmonary function of patients was significantly lower than that of the left after the damage of the outer rear side incision thoracotomy operation,and can significantly shorten during one lung ventilation and chest open time.
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