两孔式胸腔镜肺叶切除术和传统三孔式胸腔镜肺叶切除术临床效果比较  

Comparison of clinical effects between two-port thoracoscopic lobectomy and traditional three-port thoracoscopic lobectomy

作　　者：吴楠[1] 石东磊[1] 徐沛然[1] 

机构地区：[1]吉林大学第二医院胸外科,吉林长春130041

出　　处：《吉林大学学报（医学版）》2014年第2期418-421,共4页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅科技发展计划项目资助课题(200705263)

摘　　要：目的:对比两孔式胸腔镜肺叶切除术(TPTL)与传统三孔式胸腔镜肺叶切除术(TTTL)的临床应用效果,阐述TPTL在临床治疗中的意义及价值。方法:回顾性分析行胸腔镜下肺叶切除的124例患者的临床资料。124例患者按照所行术式的不同分为TPTL组60例(采用TPTL、淋巴结廓清术)和TTTL组64例(采用TTTL、淋巴结廓清术)。比较2组患者手术时间、术中出血量、术后盐酸哌替啶用量、术后拔除胸引管时间、术后住院时间和术后6个月患侧上肢活动后不适者的例数。结果:TPTL组患者切口长度[(4.0±0.2)cm]小于TTTL组患者切口长度[(6.2±0.3)cm](P<0.05);TPTL组患者术后盐酸哌替啶的用量[(125±35)mg]小于TTTL组患者术后盐酸哌替啶的用量[(240±46)mg](P<0.05)。TPTL组有2例患者术后6个月患侧上肢活动后不适,TTTL组有11例患者术后6个月患侧上肢活动后不适。2组患者手术时间、术中出血量、术后胸引管拔除时间和术后住院时间比较差异无统计学意义(P>0.05)。结论:与TTTL比较,TPTL可以减小切口长度、减轻患者术后疼痛、提高患者术后生活质量。Objective To compare the clinical effects between two-port thoracoscopic lobectomy （TPTL） and traditional three-port thoracoscopic lobectomy（TTTL）, and to charify the significance and value of TPTL in clinical treatment. Methods Retrospective analysis of clinical data of 124 patients with lung cancer undergoing thoracoscopic lobectomy were done, and the patients were divided into two groups according to different surgical methods： TPTL group（n=60, TPTL and lymph nodes dissection） and TTTL group （n= 6, TTTL and lymph nodes dissection）. The length of incision, mean operation time, average intraoperative bleeding, hydrochloride dosage, average postoperative chest tube duration, average postoperative hospital stay, and the number of the patients with upper limb discomfort after action 6 months after operation in two groups were compared. Results The length of incision of the patients in TPTL group was shorter than that in TTTL group（4.0 cm±0.2 cm, 6.2 cm±0.3 cm） （P〈0.05）. The hydrochloride dosage using after operation of the patients in TPTL group was less than that in TTTL group （125 mg±35 mg, 240 mg±46 mg） （P〈0.05）. There were 2 patients with upper limb discomfort after action 6 months after operation in TPTL group and 11 patients in TTTL group. There were no differences of mean operation time, average intraooerative bleeding, average postoperative chest tube duration, and average postoperative hospital stay between two group （P〉 0. 05）. Conclusion Compared with TTTL, TPTL can reduce the length of incision, relieve postoperative pain, and improve postoperative life quality of the patients.

关 键 词：两孔式胸腔镜肺叶切除术 传统三孔式胸腔镜肺叶切除术 肺肿瘤 

分 类 号：R655[医药卫生—外科学]