CAJ | 학술논문

目的：探讨胃代食管颈部吻合的两种手术路径对胸中上段食管癌患者围手术期呼吸功能的影响。方法：选择行胃代食管颈部吻合患者38例，经胸骨后颈部吻合16例（胸骨后组），经食管床颈部吻合22例（食管床组）。监测两组患者围手术期肺功能及血气分析的主要指标。结果：两组患者肺活量占预计值百分比（VC%）、第1秒用力呼气量占预计值百分比（FEV1%）、动脉血氧分压（PaO2）术后均出现不同程度的降低。与胸骨后组比较，食管床组VC%和PaO2在手术5 d后降低更为明显（P＜0.05），而FEV1%在术后第7天后降低更为显著（P＜0.05）。结论：胸中上段食管癌切除术后，经食管床颈部吻合较经胸骨后颈部吻合对围手术期呼吸功能的影响更大。
목적：탐토위대식관경부문합적량충수술로경대흉중상단식관암환자위수술기호흡공능적영향。방법：선택행위대식관경부문합환자38례，경흉골후경부문합16례（흉골후조），경식관상경부문합22례（식관상조）。감측량조환자위수술기폐공능급혈기분석적주요지표。결과：량조환자폐활량점예계치백분비（VC%）、제1초용력호기량점예계치백분비（FEV1%）、동맥혈양분압（PaO2）술후균출현불동정도적강저。여흉골후조비교，식관상조VC%화PaO2재수술5 d후강저경위명현（P＜0.05），이FEV1%재술후제7천후강저경위현저（P＜0.05）。결론：흉중상단식관암절제술후，경식관상경부문합교경흉골후경부문합대위수술기호흡공능적영향경대。
Objective To explore the effects of two operations on perioperative respiratory function after cervical esophagogastrostomy for patients with esophageal carcinoma.MethodsThirty eight patients with esophageal cancer underwent cervical esophagogastrostomy were retrospectively analyzed.The site of esophageal anastomosis was at neck after sternum in 16 cases,and at neck through esophageal bed in other 22 cases.Blood gas analysis and pulmonary function were monitored in these patients before operation and in 14 days after operation.Results For percentage of predicted vital capacity(VC%),forced expiratory volume in 1 second percentage of predicted value(FEV1%) and arterial oxygen pressure(PaO2) after surgery in two group patients,there are different degrees of reduction.Compared with group sternum,VC% and PaO2 decreased significantly 5 days after surgery in group esophageal bed(P<0.05),and FEV1% reduction in postoperative day 7 is particularly significant(P<0.05).ConclusionAfter esophagectomy,cervical esophagogastrostomy through esophageal bed has significant negative effect on perioperative respiratory function.