34例胸腔镜下肺楔形切除与21例肺段切除对位于肺段P区的ⅠA1期非小细胞肺癌治疗比较  

Comparison of 34 cases of thoracoscopic wedge resection and 21 cases of segmental resection for stage ⅠA1 non-small cell lung cancer in area P

作　　者：刘会宁 彭军 任迎春[1] 杨光 王文豪 刘金锋[1] 田勍[1] LIU Huining;PENG Jun;REN Yingchun;YANG Guang;WANG Wenhao;LIU Jinfeng;TIAN Qing(Department of Thoracic Surgery,the First Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei,China)

机构地区：[1]河北医科大学第一医院胸外科,河北石家庄050000

出　　处：《山东大学学报（医学版）》2022年第11期38-43,共6页Journal of Shandong University:Health Sciences

基　　金：2022年政府资助优秀人才项目(LS202210)

摘　　要：目的 探讨根据影像资料划分病灶所在的肺段位置,来选择位于P区的ⅠA1期非小细胞肺癌的胸腔镜微创手术方法,比较根据新的肺段分区方法采取手术方式的情况及预后。方法 回顾性分析接受胸腔镜下肺楔形切除术和肺段切除术的患者55例,以手术方式不同分为楔形切除术组(A组,n=34)和肺段切除术组(B组,n=21)。结果 位于P区的ⅠA1期非小细胞肺癌,A组的手术时间为(18.50±5.55)min, B组为(61.23±9.83)min;术后住院时间两组分别为(3.14±0.95)d和(4.95±1.39)d;术中出血量两组分别为(12.67±6.54)mL和(103.71±16.99)mL;住院经济花费两组分别为(3.59±0.50)万元和(6.19±1.02)万元;术后肺漏气两组分别为2例(5.88%)和6例(28.57%),上述指标两组间差异均有统计学意义(P<0.05)。单因素Logistic回归分析显示,手术时间、术后住院时间及肺漏气与不同的手术方式之间有统计学意义的关联(P<0.05)。多因素二分类Logistic回归分析显示,与B组相比,A组能缩短手术时间(OR=2.58,95%CI:1.71~3.90,P<0.001)、术后住院时间(OR=2.91,95%CI:1.01~8.84,P=0.04)和减少肺漏气(OR=7.12,95%CI:1.13~37.21,P=0.04)。结论 ⅠA1期非小细胞肺癌患者,病灶位于P区采取的胸腔镜下肺楔形切除术比采取肺段切除术具有明显的优势。Objective To investigate the selection of minimally invasive thoracoscopic surgery for stage ⅠA1 non-small cell lung cancer(NSCLC) in area P by dividing the lung segment location of the lesion according to the imaging data, and to compare the prognosis of the two methods. Methods A retrospective analysis was performed on 55 patients who underwent thoracoscopic wedge resection and segmentectomy, and the patients were divided into wedge resection group(group A, n=34) and segmentectomy group(group B, n=21). Results In groups A and B, the operation time, postoperative hospital stay, intraoperative bleeding, hospitalization costs, and incidence of postoperative pulmonary air leakage were(18.50±5.55) vs.(61.23±9.83),(3.14±0.95) d vs.(4.95±1.39) d,(12.67±6.54) mL vs.(103.71±16.99) mL,(35,900±5,000) yuan vs.(61,900±10,200) yuan, 5.88%(2 cases) vs. 28.57%(6 cases), respectively, with statistically significant differences(all P<0.05). Univariate Logistic regression analysis showed a significant correlation between operation time, postoperative hospital stay, incidence of lung leakage and different operation methods(P<0.05). Multivariate binary Logistic regression analysis showed that compared with group B, group A had shortened operation time(OR=2.58, 95%CI: 1.71-3.90, P<0.001), shorter postoperative hospital stay(OR=2.91, 95%CI: 1.01-8.84, P=0.04) and reduced incidence of lung leakage(OR=7.12, 95%CI: 1.13-37.21, P=0.04). Conclusion For patients with stage ⅠA1 NSCLC, thoracoscopic wedge resection of lung with lesion located in area P has a significant advantage over segmental resection.

关 键 词：非小细胞肺癌 新肺段分区 P区 肺楔形切除 肺段切除 

分 类 号：R734.2[医药卫生—肿瘤]