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目的探讨食管癌围术期平原地区和中度高原地区(1517m)多器官功能指标参数的变化规律。方法按统一标准对44例拟行开胸食管癌切除胃食管吻合术病例,根据所在地区分为平原对照组(FCG,8例)、中度高原对照组(MCG,20例)和中度高原肺保护组(MTG,16例),FCG组和MCG组均按常规进行围术期肺功能检查、呼吸道准备。MTG组除上述常规准备外另于术前每日2次服用复方红景天胶囊2粒。3组均按计划采集术前、术后1、3、5d血气和多器官生化指标。结果术前和术后3组的血气差异均有统计学意义,P<0·01,其他多器官功能指标术前差异无统计学意义,P>0·05,但术后1、3、5d MCG和MPG的变化也明显重于FCG,P<0·05。结论同类手术,手术前、后多器官功能指标参数有随海拔上升而加重的趋势,其中尤以血气指标较显著,提示海拔≥1517m时在评估病情发展,判别ARDS/MODS诊断标准上是一个有意义的分界线,值得临床参考。
Objective To investigate the changes of parameters of multiple organ function indexes in the perioperative plain area and moderate altitude area (1517m) of esophageal cancer. Methods According to the uniform standard, 44 cases undergoing esophagectomy for thoracic esophageal cancer were divided into three groups: control group (FCG, 8 cases), moderate plateau control group (MCG, 20 cases) and moderate high altitude lung Protective group (MTG, 16 cases), FCG group and MCG group were routinely performed perioperative pulmonary function tests, respiratory preparation. MTG group in addition to the above conventional preparation and the other in the preoperative day 2 times taking compound Rhodiola capsules 2. Blood gas and multi-organ biochemical indexes of the three groups were collected preoperatively, 1,3,5 days after surgery as planned. Results There were significant differences in blood gas between the three groups before and after operation (P <0.01). There was no significant difference in other multi-organ function indexes before operation (P> 0.05) The changes of MCG and MPG were also significantly higher than that of FCG, P <0.05. Conclusions The parameters of multiple organ function indexes in the same operation, before and after surgery tended to increase with elevation. Among them, the blood gas index was more significant, which indicated that there was a statistically significant difference between ARDS / MODS criteria Meaning of the dividing line, it is worth clinical reference.