电视胸腔镜与小切口开胸治疗临床早期非小细胞肺癌患者术后生活质量的前瞻性随机对照研究  

Quality of Life after Video-assisted Thoracoscopic Surgery or Minimal Incision Thoracotomy for Early Stage Non-small Cell Lung Cancer : A Prospective,Randomized Controlled Trial

作　　者：龙浩[1,2,3] 郑燕[1,2,3] 林勇斌[1,2,3] 司徒冬荣[1,2,3] 马国伟[1,2,3] 姜龙[1,2,3] 

机构地区：[1]中山大学肿瘤防治中心胸科 [2]中山大学肺癌研究中心 [3]华南肿瘤学国家重点实验室,广州510060

出　　处：《中国胸心血管外科临床杂志》2012年第2期130-135,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：中山大学临床医学研究5010计划项目(2007039)~~

摘　　要：目的比较电视胸腔镜手术(video-assisted thoracoscopic surgery,VATS)与小切口开胸手术(minimalincision thoracotomy,MIT)治疗临床早期非小细胞肺癌(non-small cell lung cancer,NSCLC)及其两种手术方式术后患者生活质量的变化特点。方法我们的研究为前瞻性随机对照临床研究生活质量的阶段分析。共纳入2008年1月1日至2011年12月10日中山大学肿瘤防治中心收治的106例NSCLC患者(男57例、女49例,平均年龄57.60岁),采用单中心、双盲试验的随机分组方法分为VATS组(n=57)和MIT组(n=49)。利用肺癌症状量表(LungCancer Symptom Scale,LCSS)评估两组患者术前、术后第1、3、6、9和12个月的生活质量。结果两组患者在年龄、性别、肿瘤所在肺叶、肿瘤病理分期、病理类型、术后并发症、肿瘤直径、手术时间、术中出血量和胸腔引流管置留时间等方面差异无统计学意义(P>0.05)。术后6个月中,VATS组内各指标评分与术前评分的差异无统计学意义(P>0.05);MIT组内术后1个月食欲[(1.04±0.71)vs.(2.00±0.83),F=6.357,P=0.021]、疲劳[(4.55±1.17)vs.(10.19±2.10),F=4.721,P=0.043]、气促[(2.18±0.86)vs.(10.26±2.05),F=10.020,P=0.005]及疾病对正常生活的影响[(5.16±1.70)vs.(17.60±3.17),F=12.319,P=0.002]评分与术前比较,差异有统计学意义。结论VATS行早期肺癌根治术后患者生活质量与术前无明显差异,术后恢复平稳。Objective To evaluate video-assisted thoracic surgery（VATS） and minimal incision thoracotomy（MIT） lobectomy for early stage non-small cell lung cancer patients and the impact upon postoperative quality of life（QOL）.Methods A prospective randomized controlled trial was conducted.From January 1,2008 to December 10,2011,the qualified patients with early stage NSCLC were recruited and randomized to VATS group（57 patients） and MIT group（49 patients）,totally 106 patients,57 males and 49 females,aged 57.60 years.The quality of life was assessed using Lung Cancer Symptom Scale（LCSS） before operation and at 1,3,6,9,12 months after operation.Results There were no significant differences between the 2 groups in age,sex,the location of tumor,tumor pathologic stage,pathological types,postoperative complications,tumor size,operative time,operative bleeding and air leak days.There were no symptoms after operation at the VATS group worse than the leve before operation.Five major symptoms,including appetite（1.04±0.71 vs.2.00±0.83,F=6.357,P=0.021）,fatigue（4.55±1.17 vs.10.19±2.10,F=4.721,P=0.043）,dyspnea（2.18±0.86 vs.10.26±2.05,F=10.020,P=0.005）,normal activity（5.16±1.70 vs.17.60±3.17,F=12.319,P=0.002） at the MIT group were deteriorated significantly at 1 month after the operation（P0.05）.Conclusion The VATS will lead to better quality of life for the patients with early stage NSCLC after surgery and lead to a smooth postoperative recovery.

关 键 词：电视胸腔镜手术 小切口开胸术 肺癌 生活质量 

分 类 号：R734.2[医药卫生—肿瘤]