孔冰 孔明 高原 刘坤坤

[摘要] 目的 分析Ivor-lewis食管癌根治术治疗食管癌的临床效果。 方法 于2015年8月～2017年4月期间我院收治的食管癌患者50例，将其按照1：1随机数字法分为两组，每组25例。对照组接受胸腹三切口食管癌根治术治疗，研究组接受Ivor-lewis食管癌根治术治疗，观察并比较两组患者治疗效果、并发症、住院时间、术中出血量、手术时间等。 结果 两组患者并发症总发生率比较，研究组12%低于对照组的32%，差异有统计学意义（P<0.05）。两组患者住院时间、经口进食时间、带鼻胃管时间、ICU时间、清扫淋巴结枚数、术中补液量和出血量、手术时间比较，研究组均低于对照组，差异有统计学意义（P<0.05）。 结论 临床治疗食管癌可给予Ivor-lewis食管癌根治术，可缩短手术时间，降低出血量，促进术后恢复，且并发症低，进而改善疾病预后，促进恢复，此手术方式有效且安全，值得推广。

[关键词] 食管癌；Ivor-lewis食管癌根治术；预后；并发症

[中图分类号] R735.1 [文献标识码] B [文章编号] 1673-9701（2018）15-0048-03

Investigation of the effect of Ivor-lewis esophageal carcinoma radical surgery on the treatment of esophageal cancer

KONG Bing KONG Ming GAO Yuan LIU Kunkun

Department of Thoracic Surgery， West Hospital of Shandong Provincial Hospital， Ji'nan 250022，China

[Abstract] Objective To analyze the clinical effect of Ivor-lewis esophageal carcinoma radical surgery on the treatment of esophageal cancer. Methods 50 patients with esophageal cancer treated in our hospital from August 2015 to April 2017 were reviewed by dividing them into 2 groups using 1：1 random number method， with 25 patients in each group. The control group received thoraco-abdominal three-cision esophageal cancer radical resection. The study group received Ivor-lewis esophageal cancer radical surgery. The treatment effects such as complications， length of stay， intraoperative blood loss and operation time in the two groups of patients were observed and compared. Results The total incidence of complications in the two groups were compared. The total incidence of complications in the study group （12%） was lower than that of the control group （32%）. The data was statistically significant （P<0.05）. The hospital stay， oral feeding time， nasogastric tube length， ICU time， number of lymph node dissections， intraoperative fluid volume and blood loss， and operation time in the study group were lower than those of the control group and the difference was statistically significant（P<0.05）. Conclusion Ivor-lewis esophageal cancer radical surgery can be given in the clinical treatment of esophageal cancer， which can shorten the operation time， reduce blood loss， promote postoperative recovery， with low complications， and then improve the prognosis of the disease， promote recovery. This surgical method is effective and safe， and is worthy of promotion.

[Key words] Esophageal cancer； Ivor-lewis esophageal cancer radical surgery； Prognosis； Complications

消化道恶性肿瘤中较为常见的一種则为食管癌（esophageal carcinoma，EC）[1]，发病部位多在胸中下段食管，预后较差。且此疾病在全球范围中存在病理类型、种族、地区差异。我国则为食管癌疾病的高发区域之一，主要为鳞癌，多在50～69岁人群中发病[2]。因环境污染日益严重，此病发病率逐年攀升，对人们生活、学习、身体健康等均造成严重威胁。近年来，临床诊断食管癌多采用病理、CT、纤维内镜、食管钡餐造影、胸片等方式，治疗方式主要为化学药物、放射性治疗、外科手术切除等，目前公认的最佳治疗方式仍然为外科手术。但手术方式的选择会影响食管切缘阳性率、清扫淋巴结范围、切除食管长度等，所以，确定手术路径相当重要。本研究纳入50例患者分为两组讨论Ivor-lewis食管癌根治术治疗的临床价值。现报道如下。

1 资料与方法

1.1 一般资料

于2015年8月～2017年4月我院收治的50例食管癌患者，每组25例。对照组：男15例，女10例，年龄58～71岁，平均（63.8±1.1）岁，肿瘤分化程度：高分化12例，中分化7例，低分化6例，TNM分期：Ⅰ期9例，Ⅱ期8例，Ⅲ期8例；……