摘要【目的】 研究胸腹腔镜联合治疗老年食管癌的应用及术后短期恢复。【方法】 选取2016年7月至2018年7月在本院治疗食管癌患者70例,采用随机数表法分为观察组和对照组,每组35例。观察组采用胸、腹腔镜联合的方式治疗,对照组采用传统手术治疗。比较两组手术时长、术中出血量、清扫淋巴结数目、术后拔管时间、住院时间等指标及术后1年患者生存情况。观测两组患者手术前后免疫功能(静脉血T细胞亚群分布)及术后并发症发生情况。【结果】 观察组术中出血量、术后拔管时间、术后住院时间均显著低于对照组(P<0.05)。术前两组患者静脉血中T细胞亚群及NK细胞含量比较差异无统计学意义(P>0.05),术后7 d,两组患者的各项指标均较术前有所下降,但对照组CD4+、CD4+/CD8+以及NK细胞含量显著低于观察组对照组(P<0.05);两组术后1年生存率比较(82.86% vs 80.00%)差异无统计学意义(P>0.05)。观察组术后并发症总发生率显著低于对照组(11.43% vs 31.42%),差异有显著性(P<0.05)。【结论】 与传统手术比较,胸腹腔镜联合根治老年食管癌临床疗效好,具有术后恢复快、并发症率低,对免疫系统影响小的优点,值得临床推广应用。
Abstract：【Objective】 To study the application and short-term postoperative recovery of thoracic and laparoscopic combined treatment for elderly patients with esophageal cancer. 【Methods】 Seventy patients aged 60 to 80 who were treated with esophageal cancer in our hospital from July 2016 to July 2018 were selected and randomly divided into observation group and control group with 35 patients in each group. The observation group was treated with chest and laparoscope combined treatment, while the control group was treated with traditional surgery, The operation time, intraoperative bleeding volume, number of lymph node dissection, extubation time and hospitalization time were compared between the two groups. The 1-year survival was compared between the two groups, and the T cell population in venous blood was measured before and after operation to analyze the immune function of the two groups. Comparisons of postoperative complications. 【Results】 The amount of bleeding during operation in the observation group was significantly less than that in the control group (P<0.05), the time of extubation after operation was significantly lower than that in the control group (P<0.05), and the length of hospitalization after operation was significantly shorter than that in the control group (P<0.05). There was no significant difference in the length of operation and the number of lymph nodes cleared between the two groups (P>0.05). There was no significant difference in cell group and NK cell content (P>0.05). On the 7th day after operation, the levels of CD4+, CD4+/CD8+ and NK cell in the control group were significantly lower than those in the observation group (P<0.05); 2 cases in the observation group were lost, and 1 case in the control group was lost. The 1-year survival rate in the observation group was 82.86% (29/35), and 80.00% (28/35) in the control group. There was no significant difference in 1-year survival rate between the two groups. The total incidence of complications in the observation group was 11.43%, which was significantly lower than that in the control group 31.42% (P<0.05). 【Conclusion】 Compared with traditional surgery, thoracic and abdominal combined radical esophagectomy for elderly esophageal cancer has better clinical efficacy, faster recovery time, lower complication rate and stronger immunity, which is worthy of clinical promotion.
张璞, 习攀. 胸腹腔镜联合在老年食管癌中的应用及术后短期恢复观察[J]. 医学临床研究, 2021, 38(5): 757-759.
ZHANG Pu, XI Pan. Application of Combined Thoracic and Laparoscope in Elderly Esophageal Cancer and Observation of Short-Term Postoperative Recovery. JOURNAL OF CLINICAL RESEARCH, 2021, 38(5): 757-759.
2021, Vol. 38 
