VATS治疗高龄早期非小细胞肺癌患者术后生活质量与开放手术的对比研究  

Comparison of the short-term quality of life in old patients with non-small cell lung cancer after lobectomy via video-assisted thoracoscopic or open surgery

作　　者：张安庆[1] 徐美青[1] 解明然[1] 梅新宇[1] 马冬春[1] 魏大中[1] 

机构地区：[1]安徽省肿瘤医院(安徽省立医院西区)胸外科,合肥230031

出　　处：《安徽医科大学学报》2014年第10期1460-1464,共5页Acta Universitatis Medicinalis Anhui

基　　金：安徽省卫生厅科技课题(编号:13zc021)

摘　　要：目的比较分析电视胸腔镜(VATS)和开胸手术治疗高龄(70岁以上)早期非小细胞肺癌(NSCLC)患者术后近期生活质量(QOL)。方法收集术后病理诊断为pT1-2N0M0高龄NSCLC患者118例。其中VATS手术患者63例,开胸手术患者55例。比较分析两组患者临床资料、术中和术后并发症发生情况,同时应用欧洲癌症研究与治疗组织QLQLC43中文版量表比较两组患者术前及术后2、4、12、24周的QOL。结果两组在性别、年龄、肿瘤位置、病理类型、病理分期、术前合并症、手术时间、术后并发症方面差异无统计学意义(P>0.05)。VATS组在术中失血量、术后胸管留置时间和术后住院日方面存在优势(P<0.05)。两组术前各项指标评分比较差异无统计学意义。VATS组术后的总体生活质量、躯体功能较开放组有明显优势(P<0.05)。症状评分包括疲倦、胸痛和手臂或肩膀疼痛VATS组均优于开胸组(P<0.05)。结论相对于开胸手术,高龄患者VATS肺叶切除术安全可靠,并且在术后24周内QOL评分存在优势。Objective To compare the short-term quality of life in old patients（ over 70 years） with non-small cell lung cancer underwent lobectomy via video-assisted thoracoscopic surgery（VATS） or open surgery. MethodsRetrospectively analyzed the medical records of 118 patients（ over 70 year） underwent surgery who were pathologi-cally dignosed with pT1-2N0M0 non-small cell lung cancer. Among these, Sixty-three patients followed VATS （VATS group） and 55 patients followed open surgery （open group）. The EORTC core questionnaire （QLQ LC-43） was applied to assess the short-term QOL of the patients before and 2, 4,12, 24 weeks after operation. Results The 2 groups were similar in terms of age, sex, tumor location, staging,incidence of comorbidities,in-hospital mortality and total morbidity. The VATS group was associated with a significant decrease in surgical blood loss, chest tube duration and postoperative stay relative to the open group（P〈0.05）. All of the global quality scale, functioning scale, general symptom scales （ or items） did not show differences before operation between the two groups. Further, the scores of global quality and physical functioning were higher in VATS group than in open group overall after operation, however, the scores of fatigue, pain, and pain in arm or shoulder were lower inverse-ly（P〈0. 05）. Conclusion Compared with open surgery,VATS shows an overall benefit on QOL for the patients with NSCLC during the follow-up of six month after lobectomy.

关 键 词：非小细胞肺癌 电视胸腔镜手术 生活质量 

分 类 号：R655.3[医药卫生—外科学]