电视胸腔镜肺叶切除术治疗早期非小细胞肺癌临床分析  

Clinical Analysis of Video-assisted Thoracoscopic Lobectomy Treating for Early Non-small Cell Lung Cancer

作　　者：罗东[1] 尹杰[1] 柯有力[1] 

机构地区：[1]湖北省武汉市第一医院心胸外科,武汉市430022

出　　处：《微创医学》2015年第1期22-24,33,共4页Journal of Minimally Invasive Medicine

摘　　要：目的观察电视胸腔镜下肺叶切除术治疗非小细胞肺癌的临床疗效。方法将经明确诊断为非小细胞肺癌且符合手术治疗的82例患者,随机分为观察组和对照组各41例,对照组采用传统肺叶切除术,观察组采用电视胸腔镜肺叶切除术,观察两组术中、术后情况、2年复发率和转移率及生存率。结果观察组术中失血量、术后总引流量、引流管留置时间、术后住院时间、镇痛药使用次数均短于或少于对照组,上述指标比较,差异有统计学意义(P<0.05);两组在手术时间、淋巴结清扫个数方面比较,差异无统计学意义。观察组发生并发症4例(9.76%),对照组发生13例(31.70%),两组术后并发症发生率比较,差异有统计学意义(χ2=4.75,P<0.05)。观察组41例中失访4例,随访率为90.24%,随访期间发生远处转移2例(4.88%),发生纵隔淋巴结转移5例(12.19%),2年无瘤生存期为87.80%(35/41),随访期间有3例死亡,2年生存率为87.80%(36/41)。对照组41例中失访3例,随访率为92.68%,随访期间发生远处转移6例(14.63%),发生纵隔淋巴结转移5例(12.19%),2年无瘤生存期为73.17%(30/41)。随访期间8例死于晚期肿瘤,2年生存率为80.78%(33/41)。两组2年无瘤生存期经卡方检验,不具有显著性差异。两组2年生存率比较,差异有统计学意义(χ2=4.22,P<0.05)。结论 VATS肺叶切除术可作为Ⅰ、Ⅱ期非小细胞肺癌的手术术式,可降低术后并发症发生率,具有肿瘤学治疗安全性。Objective To observe the clinical curative effect of non-small cell lung cancer treated by video-assisted thoracoscopic lobectomy. Methods 82 cases diagnosed with non-small cell lung cancer were randomly divided into the control group and the control group, 41 cases each group. Traditional lobectomy was performed in the observation group, while video-assisted thoracoscopic lobectomy was performed tin the observation group. Intra-operative and post-operative situations, 2-year rates of metastasis, recurrence and survival were compared. Results The intraoperative blood loss, the total flow and drainage tube indwelling, length of hospital stay, postoperative analgesia drug use frequency of the observation group were shorter or less than those of the control group （ P 〈 0.05 ）. There was no difference in terms of the number of dissected lymph nodes and the operation time. There were complications in 4 cases in the observation group （9.76%）, and 13 cases in the control group （31.70% ）（P 〈 0.05 ）. In the observation group, 4 cases were lost follow-up, 2 cases had distant metastasis （d. 88% ）, 5 cases had mediastinal lymph node metastases （ 12. 19% ）, and 2-year disease-free survival rate was 87.80% （35/41）, 3 cases died during the follow-up period, and 2-year survival rate was 87.80% （36/41）. Of the control group, 3 were lost to follow-up, with the follow-up rate of 92.68%, 6 cases had distant metastasis （14. 63% ）, 5 cases had mediastinal lymph node metastases（ 12.19% ） , 2-year disease-free survival rate was 73. 17% （ 30/41 ）, 8 patients died of advanced cancer during the follow-up period, 2-year survival rate was 80.78% （33/41）. The 2-year disease-free survival rate showed no significant difference, and the 2-year survival rate showed significant difference （ X2 = 4.22, P 〈 0. 05）. Conclusion VATS lobeetomy treating for Ⅰ , Ⅱ stage non-small cell lung cancer results in fewer postoperative complications than thoracotomy, showing security of oncology therap

关 键 词：电视胸腔镜 肺叶切除术 非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤]