管状胃与传统缩胃手术治疗食管癌近期临床疗效对比分析-外科学(胸外科)专业论文.docxVIP

— — PAGE 1— 摘 要 管状胃与传统缩胃手术治疗食管癌近期 临床疗效对比分析 研究生：阿曼吐尔·介恩什 导师：伊力亚尔·夏合丁 教授 摘 要 目的：探讨食管癌切除管状胃食管吻合与传统胃食管端侧吻合术对患者术后近 期临床疗效对比分析。方法：选取自2009年3月～2010年3月手术治疗，治愈出院的 胸上段、中下段、下段食管癌术后患者35 例作为研究对象，通过手术记录描述病灶 所在部位及吻合方式分组，管状胃吻合18 例，传统胃食管端侧吻合17 例，术后一 个月检测患者主要呼吸功能指标：肺活量(VC)、用力肺活量(FVC)、第一秒用力肺 活量(FEV 1)、最大通气量(MVV ) 应用实际值占预计值的百分比表示，分析其肺功 能主要指标变化，评价肺功能改变；结合常规上消化道钡餐透视及胸片检查进行分 析术后常见并发症情况。结果：两组术前主要肺功能指标及一般情况无显著性差异。 术后一个月对VC%、FVC %、MVV %的影响差异有统计学意义(P 0. 05)， 而对 FEV 1 %的影响无统计学意义(P 0. 5)，吻合口狭窄、肺部感染等术后并发症差异有 统计学意义(P 0. 05)，管状胃吻合比较传统胃食管端侧吻合，吻合口狭窄、胸胃综 合征及明显反流性食管炎等并发症发生率明显降低。结论：管状胃食管重建消化道 更符合生理解剖的要求，术后患者肺功能恢复较明显，术后并发症发生率明显降低， 改善了患者术后生活质量。 关键词：食管癌；管状胃；术后肺功能；术后并发症。 新疆医科大学医学硕士学位论文 Comparative clinical analysis on short-term therapeutic effects of gastric tube and traditional stomach in esophageal cancer patients Postgraduate: Amantuer Jieenshi Supervisor: Ilyar Sheyhidin Abstract Objective: To evaluate clinical therapeutic effects of gastric tube and traditional stomach on respiratory function and postoperative complications after esophagectomy in esophagreal cancer patients. Methods: From March 2009 to March 2010, clinical data of 35 EC patients who received esophagectomy, including 18 cases of esophagogastric anastomosis with gastric tube, and 17 cases of esophagogastric anastomosis with traditional stomach. Respiratory functions were tested one month after operation, including vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second（FEV 1）, maximal voluntary ventilation(MVV), according to practical value/ prediction value ratio and main respiratory function index to evaluate changes on postoperative respiratory function Postoperative complications were also studied in terms of chief complains , upper digestive tract barium meal test, thoracic X-ray examination. Results: There is no significant difference of preoperative lung respiratory function index and general complains in two groups. Significant difference is present on VC%, FVC % and MVV% one month after op