早期纤维支气管镜灌洗吸痰在微创食管癌术后肺部并发症中的临床研究

目的探讨纤维支气管镜(纤支镜)灌洗吸痰在预防及治疗食管癌术后肺部并发症中的作用。方法回顾性分析纳入我院胸心外科2016年1月至2019年1月收治的98例微创食管癌手术患者的临床资料,其中50例术后予以纤支镜灌洗吸痰作为试验组,48例行常规物理治疗作为对照组,对比分析两组患者术后发生肺部感染、呼吸衰竭、吻合口瘘的情况,以及引流管留置时间、抗生素使用时间、平均住院日等。结果试验组在术后肺部感染(20.0%和45.8%,χ^2=7.43、P=0.006)、呼吸衰竭(2.0%和12.5%,χ^2=4.07、P=0.000)、术后引流管留置(7.7±1.9)d和(9.9±2.3)d,t=-5.28、P=0.000]、抗生素使用(8.2±1.5)d和(11.6±2.5)d,t=-5.90、P=0.000]低于对照组;两组在吻合口瘘的发生率、平均住院时间上差异无统计学意义(均P>0.05)。结论微创食管癌术后早期经纤支镜灌洗吸痰,可以减少围术期风险及术后并发症,提高治疗效果,临床中值得推广。

A clinical study on the effects of early fiberoptic bronchoscopic lavage and sputum aspiration on pulmonary complications after minimally invasive esophageal cancer surgery

Objective To explore the role of fiberoptic bronchoscopic lavage and sputum aspiration in preventing and treating pulmonary complications after esophageal cancer surgery.Methods Clinical data of 98 patients undergone minimally invasive esophageal cancer treatment in our hospital from January 2016 to January 2019 were retrospectively analyzed.Fifty patients undergone bronchoscopic lavage and sputum aspiration were assigned to the experimental group and 48 patients receiving routine physical therapy to the control group.The incidences of pulmonary infection,respiratory failure,anastomotic leakage,drainage tube retention time after operation,duration of antibiotic use,average length of stay,etc.,were compared between the two groups.Results The incidences of pulmonary infection(20.0%vs.45.8%,χ^2=7.43,P=0.006),respiratory failure(2.0%vs.12.5%,χ^2=4.07,P=0.000),drainage tube retention time(7.7±1.9)d vs.(9.9±2.3)d,t=-5.28,(P=0.000)],antibiotic use time(8.2±1.5)d and(11.6±2.5)d,t=-5.90,(P=0.000)]were lower in the experimental group than in the control group.There was no significant difference in the incidence of anastomotic leakage or the average hospitalization time between the two groups(all P>0.05).Conclusions Early sputum aspiration via fiberoptic bronchoscope after minimally invasive esophageal cancer surgery can reduce perioperative risks for complications,improve the therapeutic efficacy,and should be encouraged in clinical practice.