电视胸腔镜手术对老年非小细胞肺癌患者术后心肺并发症的影响分析  

Video Assisted Thoracic Surgery:Effects on Postoperative Cardiopulmonary Complications in Elderly NSCLC Patients

作　　者：张卫强[1] 左建新[1] 谭健[1] 梁海龙[1] 赵京[1] 

机构地区：[1]北京军区总医院胸外科,北京市100700

出　　处：《中国全科医学》2014年第2期220-222,共3页Chinese General Practice

摘　　要：目的探讨电视胸腔镜手术(VATS)对老年非小细胞肺癌(NSCLC)患者术后心肺并发症的影响。方法选取2009年1月—2013年11月我院确诊的符合纳入和排除标准的老年NSCLC患者80例,并采用随机数字表法将其分为VATS组(43例)和对照组(37例),分别采取电视胸腔镜肺叶切除和传统开胸肺叶切除予以治疗。比较两组患者术后1周内的并发症发生情况及手术前后1周内的心、肺功能评定情况。结果 (1)VATS组共有8例患者术后发生并发症,总并发症发生率为18.6%,其中4.7%(2/43)的患者发生心脏并发症,14.0%(6/43)的患者发生肺部并发症;对照组患者中共有22例发生并发症,总并发症发生率为59.5%,其中24.3%(9/37)的患者并发症发生于心脏,35.1%(11/37)的患者并发症发生于肺部。VATS组总并发症发生率低于对照组(P<0.05);VATS组患者心脏和肺部的并发症发生率均低于对照组(P<0.05)。(2)术前两组患者的心、肺功能指标比较,差异无统计学意义(P>0.05);术后VATS组肺功能指标第1秒用力呼气容积(FEV1)和最大通气量(MVV)高于对照组(P<0.05),VATS组心率低于对照组(P<0.05)。结论老年NSCLC患者采取VATS进行开胸手术可降低术后心肺并发症发生率,加快其术后心肺功能的恢复,值得在临床上进一步推广应用。Objective To explore the effects of video assisted thoracic surgery （VATS） on postoperative cardiopulmu- nary complications in elderly none - small - ceil lung cancer （NSCLC） patients. Methods Eighty elderly patients diagnosed as NSCLC were divided randomly into groups VATS （ n = 43 ）, control （ n = 37 ）. The incidences of complications 1 week after op- eration and the evaluations of heart and lung functions 1 week before and after operation were compared between 2 groups. Re- sults Eight patients had complication 1 week after operation （ 18. 6% ）, including 2 heart complications （4. 7% ）, 6 lung complications （14. 0% ）in VATS group, and 22 （59. 55）, 9 （24. 3% ）, 11 （35.1%）, respectively, in control group. The total incidence of complications was lower in VATS group than in control group （ P 〈 0. 05 ）. The incidence of heart or lung complications was lower in VATS group than in control group （ P 〈 0. 05 ）. There was no significant difference in parameter of heart lung function between 2 groups before operation （P 〉0. 05）. The forced expiratory volune in 1 second （FEVI） and maxi- mal voluntary ventilation （MVV） were higher in VATS group than in control group after operation （P 〈0. 05）. Conclusion VATS used in thoracotomy can reduce postoperative heart or lung complications and improve the recovery of heart, lung functions in elderly NSCLC patients, which is worthy of further clinical application.

关 键 词：胸腔镜 胸外科手术 电视辅助 癌 非小细胞肺 手术后并发症 老年人 

分 类 号：R619.9[医药卫生—外科学]