胸腔镜手术对胸中下段早期食道癌患者IgA IgG IgM及生活质量的影响

doi:10.3969/j.issn.1006-6233.2019.02.020

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摘要 目的:探讨胸腔镜手术对胸中下段早期食道癌患者IgA、IgG、IgM及生活质量的影响,并分析临床效果。方法:选取2015年11月至2016年11月在我院接受治疗的胸中下段食道癌患者84例,采用简单随机分组分为观察组(n=43)和对照组(n=41)。对照组行开胸手术治疗,观察组行胸腔镜手术治疗。比较患者手术时间、术中出血量、住院时间、完全切除率,比较术前、术后免疫功能指标免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、生活质量指标评分变化,记录患者术后1年、3年、5年生存率,记录患者乳糜胸、气胸、喉返神经损伤、吻合口瘘、心律失常等并发症发生率。结果:观察组患者手术时间、住院时间短于对照组(P<0.05);观察组术中出血量低于对照组(P<0.05);观察组完全切除率93.33%,对照组完全切除率69.78%,观察组高于对照组(P<0.05);术后,两组患者免疫功能指标IgA、IgG、IgM均有降低,但观察组明显高于对照组(P<0.05)。术后,两组患者躯体功能、社会功能、物质生活、总体健康等生活质量指标均有提高,但观察组明显高于对照组(P<0.05);术后,对患者进行为期5年的电话随访,结果表明,观察组术后1年生存率93.02%、3年生存率81.39%、5年生存率74.41%明显高于对照组68.29%、58.53%、48.78%(P<0.05)。治疗期间,两组患者均出现乳糜胸、气胸、喉返神经损伤、吻合口瘘、心律失常等并发症,观察组总发生率8.89%明显低于对照组34.88%(P<0.05)。结论:给予胸中下段早期食道癌患者胸腔镜手术治疗,可缩短患者住院时间,提高手术切除效果,对机体免疫功能损伤小,提高患者生活质量、术后生存率,安全性高,是一种安全有效的治疗方法。

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关键词 ：食道癌, 切除效果, 胸腔镜, 早期

Abstract：Objective: To investigate the effects of thoracoscopic surgery on IgA, IgG, IgM and quality of life in patients with early and middle thoracic esophageal cancer, and to analyze the clinical effects. Methods: Eighty-four patients with lower thoracic esophageal cancer who were treated in our hospital from November 2015 to November 2016 were enrolled. The patients were divided into observation group (n=43) and control group (n=41) by simple random grouping. The control group underwent thoracotomy and the observation group underwent thoracoscopic surgery. Compare the operation time, intraoperative blood loss, hospitalization time, complete resection rate, compare the preoperative and postoperative immune function indexes immunoglobulin A (IgA), immunoglobulin G (IgG), immunoglobulin M (IgM), The quality of life index scores were changed. The 1st, 3rd, and 5th year survival rates were recorded. The incidence of complications such as chylothorax, pneumothorax, recurrent laryngeal nerve injury, anastomotic leakage, and arrhythmia were recorded. Results: The operation time and hospitalization time of the observation group were shorter than those of the control group (P<0.05). The intraoperative blood loss was lower in the observation group than in the control group (P<0.05). The complete resection rate was 93.33% in the observation group and 69.78% in the control group. The observation group was higher than the control group (P<0.05). After operation, the immune function indexes of IgA, IgG and IgM were decreased in the two groups, but the observation group was significantly higher than the control group (P<0.05). After operation, the quality of life indicators such as physical function, social function, material life and overall health of the two groups were improved, but the observation group was significantly higher than the control group (P<0.05). After the operation, the patient was given a 5-year telephone call. After follow-up, the results showed that the 1-year survival rate of the observation group was 93.02%, the 3-year survival rate was 81.39%, and the 5-year survival rate was 74.41%, which was significantly higher than the control group of 68.29%, 58.53%, and 48.78% (P<0.05). During the treatment, complication of chylothorax, pneumothorax, recurrent laryngeal nerve injury, anastomotic leakage and arrhythmia occurred in both groups. The total incidence of 8.89% in the observation group was significantly lower than that in the control group (34.88%) (P<0.05). Conclusion: Thoracoscopic surgery for patients with early and middle thoracic esophageal cancer can shorten the length of hospital stay, improve the surgical resection, reduce the immune function of the body, improve the quality of life, postoperative survival rate, and high safety. It is safe and effective.

Key words： Esophageal cancer Resection effect Thoracoscopy Early stage

基金资助:安徽省卫生和计划生育委员会科研计划项目,(编号:15tb009)

引用本文:

司盼盼, 宁光耀, 卢晨, 刘文建, 张春盛. 胸腔镜手术对胸中下段早期食道癌患者IgA IgG IgM及生活质量的影响[J]. 河北医学, 2019, 25(2): 250-254.
SI Panpan, NING Guangyao, LU Chen, et al. Effect of Thoracoscopic Surgery on IgA IgG IgM and Quality of Life in Patients with Early and Middle Thoracic Esophageal Cancer. HeBei Med, 2019, 25(2): 250-254.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2019.02.020 或 http://www.hbyxzzs.cn/CN/Y2019/V25/I2/250

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