胸腔镜手术治疗老年非小细胞肺癌的优劣势分析  

Analysis on advantages and disadvantages of thorascopic surgery in treatment of senile patients with NSCLC

作　　者：李立彬[1] 高妍[2] 李栋[1] 郭志刚[1] 

机构地区：[1]冀中能源邢台矿业集团有限责任公司总医院外一科,河北邢台054000 [2]冀中能源邢台矿业集团有限责任公司总医院内三科,河北邢台054000

出　　处：《西南国防医药》2015年第6期610-613,共4页Medical Journal of National Defending Forces in Southwest China

摘　　要：探讨电视胸腔镜手术治疗老年非小细胞肺癌（NSCLC）的优劣性。根据术式将2010年1月~2013年7月我院收治的135例老年NSCLC患者分为观察组（69例）与对照组（66例），观察组采用电视胸腔镜辅助小切口手术治疗，对照组采用常规开胸手术治疗。手术后所有患者接受为期12个月的随访。（1）两组手术时间、淋巴结清扫数目无统计学差异（P〉0.05），观察组手术切口长度、术中出血量、引流管留置时间、术后镇痛时间、术后住院时间显著小于对照组，住院费用显著高于对照组（均P〈0.05）。（2）两组胸腔漏气、胸腔积液、肺部感染、肺不张等并发症发生率无统计学差异P〈0.05），观察组静脉血栓栓塞发生率显著低于对照组（P〈0.05）。（3）随访期内，两组复发率、转移率、1年生存率无统计学差异（P〈0.05）。电视胸腔镜辅助小切口手术治疗老年NSCLC的远期疗效与常规开胸手术相当，且具有手术创伤小、并发症发生率低、术后恢复快等优点，但是该术式亦存在不足之处，如有严格的适应证、对手术者操作技术要求较高、手术费用高等。To explore the advantages and disadvantages of video-assisted thoracic surgery in treatment of the senile patients with non-small cell lung cancer （NSCLC）. Total 135 senile patients with NSCLC to receive treatment in our hospital from Jan. of 2010 to July of 2013 were divided into the observation group （n = 69） and the control group （n = 66）. The observation group received video-assisted mini-thoractomy （VAMT） and the control group received routine open thoracotomy. The follow-up lasted for 12 months after the operations. （1） The operation times and the numbers of lymph node dissection in the two groups has no statistic difference （P〉0.05）, the operative incision length, intraoperative bleeding volume, postoperative analgesia time and length of hospitalization time in the observation group were obviously lower than those in the control group, but the cost of hospitalization was significantly higher than that in the control group （all P〈 0.05）. （2）The complications such as air leakage of thoracic cavity, pleural effusion, pulmonary infection and pulmonary atelectasis in the two groups had no statistic difference （ P〈0.05）. The recurrence of venous thromboembolism in the observation group was significantly lower than that in the control group （P〈0.05）. （3） In the follow-up period, the recurrence rate, metastasis rate and 1-year survival rate between the two groups had no statistic difference （ P〈0.05）. The long-term curative effect of video-assisted mini-thoractomy （VAMT） is equivalent to that of routine open thoracotomy. Its advantages include small operation wound, low recurrence rate of complications and fast postoperative recovery; but it has disadvantages, including strict indication, high requirements on the operating skills and specifications and high operative cost.

关 键 词：胸腔镜 老年 非小细胞肺癌 优劣性 

分 类 号：R734.2[医药卫生—肿瘤]