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目的探讨联合麻醉下行胸腹腔镜微创手术在新辅助放化疗治疗食管癌中的临床价值。方法将206例食管癌患者随机分为试验组和对照组各103例。2组患者均给予胸腹腔镜微创手术及新辅助放化疗,试验组选择联合麻醉,对照组选择全身麻醉治疗,检测2组患者麻醉后收缩压、舒张压、心率、麻醉苏醒时间和麻醉药物维持用量等指标。根据患者麻醉后临床表现评估麻醉效果。观察2组不良反应发生情况。结果试验组患者收缩压、舒张压及心率均低于对照组、麻醉苏醒时间短于对照组,麻醉药物维持用量小于对照组,麻醉总有效率明显高于对照组,麻醉后不良反应发生率明显低于对照组,差异均有统计学意义(P<0.05)。结论全身麻醉联合胸段硬膜外阻滞麻醉下行胸腹腔镜微创手术在新辅助放化疗治疗食管癌中具有显著的临床治疗价值。
Objective To investigate the clinical value of combined thoraco-laparoscopic minimally invasive surgery with neoadjuvant chemoradiotherapy in the treatment of esophageal cancer. Methods 206 patients with esophageal cancer were randomly divided into experimental group and control group of 103 cases. The patients in both groups were given minimally invasive thoracoscopic laparoscopic surgery and neoadjuvant chemoradiation. The experimental group was given the combined anesthesia while the control group was treated by general anesthesia. The systolic blood pressure, diastolic blood pressure, heart rate, anesthesia recovery time, Maintain the amount of other indicators. The anesthetic effect was evaluated according to the patient’s clinical performance after anesthesia. Two groups of adverse reactions were observed. Results The systolic blood pressure, diastolic blood pressure and heart rate in the experimental group were lower than those in the control group. The recovery time of anesthesia was shorter than that of the control group. The maintenance dosage of narcotic drugs was less than that of the control group. The total effective rate of anesthesia was obviously higher than that of the control group. Lower than the control group, the difference was statistically significant (P <0.05). Conclusion Thoraco-laparoscopic minimally invasive surgery with general anesthesia combined with thoracic epidural anesthesia has significant clinical value in neoadjuvant chemoradiotherapy for esophageal cancer.