胸腔镜食管癌切除术后肺部感染患者肺功能和炎症因子水平的关系研究

目的:研究胸腔镜食管癌切除术后肺部感染患者肺功能和炎症因子水平的关系。方法:选取2015年3月～2018年7月我院收治的食管癌患者120例为研究对象,将其以随机数字表法分成对照组和观察组。对照组予以传统开胸手术治疗,观察组则予以胸腔镜食管切除术治疗。分别比较两组术后肺部感染发生情况、手术前后肺功能以及炎症因子水平变化情况,并分析胸腔镜食管癌切除术后肺部感染患者肺功能与炎症因子的关系。结果:观察组患者术后肺部感染发生率为13.33%(8/60),低于对照组的36.67%(22/60),差异有统计学意义(P0.05)。术后观察组用力肺活量(FVC)、第1秒用力呼气量(FEV1)、FEV1/FVC均高于对照组,差异均有统计学意义(均P0.05)。术后1 d、术后5 d观察组白细胞介素-6(IL-6)、白细胞介素-10(IL-10)以及C反应蛋白(CRP)水平均低于对照组,差异均有统计学意义(均P0.05)。经Pearson相关性分析可得:胸腔镜食管癌切除术后肺部感染患者FVC、FEV1、FEV1/FVC与IL-6、IL-10、CRP均呈负相关性(均P0.05)。结论:胸腔镜食管癌切除术可显著降低患者肺部感染发生风险,且术后肺部感染患者肺功能与炎症反应存在密切相关,降低术后肺部感染发生率的机制可能与减轻机体炎症反应有关。

Relationship between Pulmonary Function and Inflammatory Factors in Patients with Pulmonary Infection after Thoracoscopic Esophagectomy

ABSTRACT Objective: To study the relationship between pulmonar function and inflammatory factors in patients with pulmonary infection after thoracoscopic esophagectomy. Methods: 120 patient with esophageal cancer who were treated in our hospital from March 2015 to July 2018 were selected as research subjects, and they were divided into observation group and control group by random number table method. The control group was treated with traditional thoracotomy, and the observation group was treated with thoracoscopic esophagectomy. The incidence of postoperative pulmonary infection, changes of pulmonary function and inflammatory factors were compared between the two groups before and after operation, and the relationship between pulmonary function and inflammatory factors in patients with pulmonary infection after thoracoscopic esophagectomy were analyzed. Results: The incidence of postoperative pulmonary infection in the observation group was 13.33% (8/60), which was lower than 36.67% (22/60) in the control group, and the difference was statistically significant (P<0.05). The forced expiratory volume (FVC), first expiratory volume (FEV1) and FEV1/FVC in the observation group were all higher than those in the control group, and the difference was statistically significant (P<0.05). The levels of interleukin-6 (IL-6), interleukin-10 (IL-10) and C reactive protein (CRP) in the observation group at 1d, 5d after operation were all lower than those in the control group, the difference was statistically significant (P<0.05). The Pearson correlation analysis showed that FVC, FEV1 and FEV1/FVC were negatively correlated with IL-6, IL-10 and CRP in patients with pulmonary infection after thoracoscopic esophagectomy (P<0.05). Conclusion: Thoracoscopic esophagectomy can significantly reduce the risk of pulmonary infection, there is a close correlation between pulmonary function and inflammatory response in patients with postoperative pulmonary infection, and the mechanism of reducing the incidence of postoperative pulmonary infection may be related to the reduction of inflammatory response.