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摘要:
目的 报道一种改良胸腹联合切口治疗贲门癌的研究。 方法 收集桂林医学院附属医院心胸外科自2007年10月至2011年10月贲门癌手术病例27例。分为三组: 改良胸腹联合切口组、经典胸腹联合切口组和左开胸组, 比较三组平均手术时间、术中出血量、拔除胸管时间、住院天数等一般项目, 以及在淋巴结清扫、术后并发症、呼吸功能影响和术后疼痛等方面的差异。 结果 改良胸腹联合切口组的平均手术时间、淋巴结情况等与经典胸腹联合切口组相近, 术后并发症及使用止痛药物少于其他二组。术后肺功能受损及恢复情况优于其他二组。 结论 此种改良胸腹联合切口入路符合贲门癌手术要求, 且创伤小、对患者心肺功能影响小, 简单实用, 易于掌握。 Abstract:Objective This report aimed to investigate a modified thoraco-abdominal incision for treating gastric cardiac carcinoma(GCC). Methods Comparative analysis was used to study three different approaches in the surgery of GCC patients in The Affiliated Hospital of Guilin Medical University from October 2007 to October 2011.One group was treated with left thoracic incision, one group with classic thoraco-abdominal incision, and one group with modified thoraco-abdominal incision.Analyses of related factors were conducted, including average operating time, perioperative blood loss, time of chest tube removal, length of hospital stay, lymph node dissection, postoperative complications and differences in respiratory functions and postoperative pain, in the patients in the three groups. Results The mean operating time and the lymph node dissection results of the patients in modified thoraco-abdominal incision were similar to those in classic thoraco-abdominal incision.Postoperative complications and use of analgesic drugs were lesser in modified thoraco-abdominal incision compared with those in the other two groups.Postoperative impairment and recovery of the pulmonary functions also exhibited favorable advantage in this group compared with the patients in left thoraco incision and classic thoraco-abdominal incision. Conclusion The diameter of the modified thoraco-abdominal incision can be in accordance to the requirements of the surgery for GCC, with the advantages of small size and less impact on the heart and lung functions in patients.The surgery is simple, practical, and easy to perform. -
表 1 改良胸腹联合切口组、经典胸腹联合切口组与左开胸组临床一般项目平均值 （x±s）
Table 1. General characteristics of the patients in the three treatment groups
表 2 淋巴结清扫情况
Table 2. The results of lymph node dissection
表 3 术后肺功能变化 （%，x±s）
Table 3. Comparison of pulmonary function after surgery
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