McKeown食管癌根治术管状胃对患者肺功能影响.docVIP

McKeown食管癌根治术管状胃对患者肺功能的影响 　　[摘要] 目的 回顾分析McKeown食管癌根治术管状胃法对术后呼吸功能的影响。 方法 选择2011年7月～2014年6月在我院行McKeown食管癌根治术患者80例，并随机分为观察组和对照组各40例，观察组术中行管状胃法，对照组术中行全胃法。测定术前1周内、术后第4周肺功能，测定术前3日内、术后第3日动脉血气分析。 结果 两组患者术后PaO2均较术前下降，术后观察组PaO2高于对照组，差异有统计学意义（P0.05）。术后两组患者FEV1%，VC%，MVV%，FVC%均较术前不同程度下降，术后观察组FEV1%，VC%，FVC%高于对照组，差异有显著性（P0.05）。 结论 管状胃法相比全胃法在术后早期及晚期影响肺功能较小 [关键词] McKeown食管癌根治术；管状胃；肺功能；动脉血气分析 [中图分类号] R735.1 [文献标识码] B [文章编号] 2095-0616（2015）20-154-03 Effect of the gastric tube on pulmonary function after McKeown esophagectomy MAO Weijun JIANG Zhiping GU Jianfeng Department of Thoracic Surgery，Changshu Second People’s Hospital，Changshu 215500，China [Abstract] Objective To retrospective analyse the effect of the gastric tube on respiratory function after McKeown esophagectomy. Methods 80 patients with gastric tube from July 2011 to June 2014 were randomly divided into observation group （40 cases） and control group （40 cases），patients in control group were treated with conventional esophagectomy，while others were treated with McKeown esophagectomy.After the treatment，the lung function and arterial blood gas of patients in both groups were observed. Results After the treatment，the PaO2 level of patients in both groups were significantly decreased （P0.05）.After the treatment，the levels of FEV1%，VC%，MVV%，FVC% of all patients significantly decreased （P0.05）. Conclusion Compared with conventional esophagectomy，the treatment of McKeown esophagectomy for patients with gastric tube has a smaller effect of tubular stomach lung function， and it is worth for clinical promotion. [Key words] McKeown esophagectomy；Gastric tube；Pulmonary function；Artery blood gas analysis 尽管胸外科治疗技术的飞速发展，但食管癌根治术仍然有较高的手术并发症发生率以及死亡率[1]，在术后早期主要为呼吸系统相关并发症[2]。食管癌根治术后胸胃扩张，影响患者呼吸功能，国内外文献多有报道。我院自2011年始McKeown食管癌根治术中应用管状胃代替食管重建消化道，回顾分析管状胃对肺功能的影响，现报道如下 1 资料及方法 　　1.1 一般资料 从2011年7月～2014年6月在我院行McKeown食管癌根治术患者80例中随机抽取40例术中行管状胃法，40例术中行全胃法（对照组）。以上病例均由同一组医师完成手术，并排除术后出现非呼吸系统并发症者。患者一般情况见表1，两组患者一般情况无统计学意义（P0.05