中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2014年
20期
3081-3083
,共3页
食管肿瘤%手术方式%肺功能%生活质量
食管腫瘤%手術方式%肺功能%生活質量
식관종류%수술방식%폐공능%생활질량
Esophageal neoplasms%Operation%Lung function%Quality of life
目的:探讨Ivor-Lewis术式对老年食管癌患者肺功能和生活质量的影响。方法将122例老年食管癌患者按照数字表法随机分为观察组和对照组各61例。对照组采用Sweet 手术,观察组采用Ivor-Lewis手术。观察两组手术时间、术中出血量、淋巴结清扫数、引流量及住院时间。比较两组患者术后3 d肺功能和术后3个月的生活质量。结果观察组手术时间、术中出血量、引流量及住院时间[(162.4±30.4)min,(260.1±33.7) mL,(1254.1±311.2) mL,(11.2±3.1) d]均少于对照组[(201.6±33.6) min,(315.2±41.3)mL,(1928.3±346.1)mL,(17.6±3.6)d](t=3.627、4.662、2.716、3.772,均P<0.05),淋巴结清扫数[(36.1±7.7)枚]多于对照组[(21.6±7.1)枚](t=9.062,P<0.05)。两组治疗前第1秒用力呼气容积(FEV1)、用力吸气肺活量(FVC)、最大呼气流量(PEF)差异无统计学意义(t=0.612、0.301、0.772,均P>0.05),对照组和观察组治疗3 d后FEV1分别为(1.89±0.47) L、(2.18±0.42) L;FVC分别为(2.44±0.31)L、(2.87±0.25)L;PEF分别为(4.01±0.26)L/s、(4.52±0.29)L/s。对照组治疗3 d后患者FEV1、FVC和PEF均明显降低(t=4.162、3.997、5.012,均P<0.05),观察组FEV1、FVC术前和术后3 d差异均无统计学意义(t=1.032、0.924,均P>0.05),观察组治疗3 d后PEF明显降低(t=3.128,P<0.05)。治疗3 d后,观察组FEV1、FVC和PEF明显高于对照组(t=5.186、3.017、3.112,均P<0.05)。对照组和观察组术前生活质量评分分别为(5.41±1.83)分和(5.31±1.77)分;术后分别为(7.01±2.16)分和(8.35±2.27)分。两组患者手术后生活质量均较术前提高,并且观察组较对照组提高更明显(t=2.864,P<0.05)。结论 Ivor-Lewis术式可以明显改善老年食管癌患者肺功能和生活质量。
目的:探討Ivor-Lewis術式對老年食管癌患者肺功能和生活質量的影響。方法將122例老年食管癌患者按照數字錶法隨機分為觀察組和對照組各61例。對照組採用Sweet 手術,觀察組採用Ivor-Lewis手術。觀察兩組手術時間、術中齣血量、淋巴結清掃數、引流量及住院時間。比較兩組患者術後3 d肺功能和術後3箇月的生活質量。結果觀察組手術時間、術中齣血量、引流量及住院時間[(162.4±30.4)min,(260.1±33.7) mL,(1254.1±311.2) mL,(11.2±3.1) d]均少于對照組[(201.6±33.6) min,(315.2±41.3)mL,(1928.3±346.1)mL,(17.6±3.6)d](t=3.627、4.662、2.716、3.772,均P<0.05),淋巴結清掃數[(36.1±7.7)枚]多于對照組[(21.6±7.1)枚](t=9.062,P<0.05)。兩組治療前第1秒用力呼氣容積(FEV1)、用力吸氣肺活量(FVC)、最大呼氣流量(PEF)差異無統計學意義(t=0.612、0.301、0.772,均P>0.05),對照組和觀察組治療3 d後FEV1分彆為(1.89±0.47) L、(2.18±0.42) L;FVC分彆為(2.44±0.31)L、(2.87±0.25)L;PEF分彆為(4.01±0.26)L/s、(4.52±0.29)L/s。對照組治療3 d後患者FEV1、FVC和PEF均明顯降低(t=4.162、3.997、5.012,均P<0.05),觀察組FEV1、FVC術前和術後3 d差異均無統計學意義(t=1.032、0.924,均P>0.05),觀察組治療3 d後PEF明顯降低(t=3.128,P<0.05)。治療3 d後,觀察組FEV1、FVC和PEF明顯高于對照組(t=5.186、3.017、3.112,均P<0.05)。對照組和觀察組術前生活質量評分分彆為(5.41±1.83)分和(5.31±1.77)分;術後分彆為(7.01±2.16)分和(8.35±2.27)分。兩組患者手術後生活質量均較術前提高,併且觀察組較對照組提高更明顯(t=2.864,P<0.05)。結論 Ivor-Lewis術式可以明顯改善老年食管癌患者肺功能和生活質量。
목적:탐토Ivor-Lewis술식대노년식관암환자폐공능화생활질량적영향。방법장122례노년식관암환자안조수자표법수궤분위관찰조화대조조각61례。대조조채용Sweet 수술,관찰조채용Ivor-Lewis수술。관찰량조수술시간、술중출혈량、림파결청소수、인류량급주원시간。비교량조환자술후3 d폐공능화술후3개월적생활질량。결과관찰조수술시간、술중출혈량、인류량급주원시간[(162.4±30.4)min,(260.1±33.7) mL,(1254.1±311.2) mL,(11.2±3.1) d]균소우대조조[(201.6±33.6) min,(315.2±41.3)mL,(1928.3±346.1)mL,(17.6±3.6)d](t=3.627、4.662、2.716、3.772,균P<0.05),림파결청소수[(36.1±7.7)매]다우대조조[(21.6±7.1)매](t=9.062,P<0.05)。량조치료전제1초용력호기용적(FEV1)、용력흡기폐활량(FVC)、최대호기류량(PEF)차이무통계학의의(t=0.612、0.301、0.772,균P>0.05),대조조화관찰조치료3 d후FEV1분별위(1.89±0.47) L、(2.18±0.42) L;FVC분별위(2.44±0.31)L、(2.87±0.25)L;PEF분별위(4.01±0.26)L/s、(4.52±0.29)L/s。대조조치료3 d후환자FEV1、FVC화PEF균명현강저(t=4.162、3.997、5.012,균P<0.05),관찰조FEV1、FVC술전화술후3 d차이균무통계학의의(t=1.032、0.924,균P>0.05),관찰조치료3 d후PEF명현강저(t=3.128,P<0.05)。치료3 d후,관찰조FEV1、FVC화PEF명현고우대조조(t=5.186、3.017、3.112,균P<0.05)。대조조화관찰조술전생활질량평분분별위(5.41±1.83)분화(5.31±1.77)분;술후분별위(7.01±2.16)분화(8.35±2.27)분。량조환자수술후생활질량균교술전제고,병차관찰조교대조조제고경명현(t=2.864,P<0.05)。결론 Ivor-Lewis술식가이명현개선노년식관암환자폐공능화생활질량。
Objective To study the influence of Ivor-Lewis surgery on lung function and quality of life of elderly patients with esophageal cancer .Methods 122 elderly patients with esophageal cancer were randomly divided into the observation group and the control group ,61 cases in each group .The control group was given Sweet surgery , observation group was given Ivor-Lewis surgery.The operative time,blood loss,number of lymph node dissection , drainage and hospitalization time were observed .Postoperative lung function 3 days after operation and life quality of patients 3 months after operation were compared between the two groups .Results The operative time,blood loss, drainage,and hospital stay in the observation group were (162.4 ±30.4) min,(260.1 ±33.7) mL,(1 254.1 ± 311.2)mL,(11.2 ±3.1)d,which were significantly lower than (201.6 ±33.6)min,(315.2 ±41.3)mL,(1 928.3 ± 346.1)mL,(17.6 ±3.6)d in the control group (t=3.627,4.662,2.716,3.772,all P<0.05).The number of lymph node dissection in the observation group was more than the control group (t=9.062,P<0.05).Before treat-ment,FEV1,FVC and PEF had no significant differences (t=0.612,0.301,0.772,all P>0.05).After treatment for 3 days,FEV1 of the control group and observation group were (1.89 ±0.47)L,(2.18 ±0.42)L;FVC were (2.44 ± 0.31)L,(2.87 ±0.25)L.PEF were (4.01 ±0.26)L/s,(4.52 ±0.29)L/s.After treatment for 3 days,FEV1,FVC and PEF in the control group were significantly decreased (t=4.162,3.997,5.012,all P<0.05).In the observation group,FEV1,FVC before and postoperative 3 days had no significant differences (t=1.032,0.924,all P>0.05), 3 days after treatment,PEF of the observation group was significantly decreased (t=3.128,P<0.05).After treat-ment for 3 days,FEV1 ,FVC and PEF of the observation group were significantly higher than those of the control group (t=5.186,3.017,3.112,P<0.05).Before surgery,scores of life quality in the control group and observation group were (5.41 ±1.83)points and (5.31 ±1.77)points.After surgery were (7.01 ±2.16)points and (8.35 ±2.27) points.Quality of life in two groups were improved after operation .Life quality of the observation group was significantly higher than the control group (t=2.864 4,P<0.05).Conclusion Ivor-Lewis surgical procedures can significantly improve lung function and quality of life in elderly patients with esophageal cancer .