全胸腔镜手术与胸腔镜辅助小切口手术对Ⅰ期非小细胞肺癌的临床疗效比较  

Clinical efficacy of video—assisted thoracoscopic surgery and video—assisted minithoracotomy for stage Ⅰ non—small cell lung cancer

作　　者：周伟鹤[1] 黄宪平[1] 章岳峰[1] 刘勇[1] 

机构地区：[1]温州医科大学附属第二医院胸外科,325027

出　　处：《浙江医学》2016年第1期39-41,48,共4页Zhejiang Medical Journal

基　　金：温州市科技局项目(Y20120156)

摘　　要：目的比较全胸腔镜手术与胸腔镜辅助小切口手术对Ⅰ期非小细胞肺癌的临床疗效。方法选择86例Ⅰ期非小细胞肺癌患者,按随机数字表法分为使用全胸腔镜手术治疗组(全胸腔镜组46例,采用3孔法)及使用胸腔镜辅助小切口手术治疗组(胸腔镜辅助组40例,采用2孔法)。比较两组患者一般手术情况、术后生存质量及无瘤生存情况。结果两组患者的手术时间、术中出血量、术后带胸管时间及住院时间比较差异均无统计学意义(均P>0,05),全胸腔镜组患者术后胸腔液引流量[(217.8士50.5)ml]和视觉模拟评分(VAS)[(3.9±0.6)分]均低于胸腔镜辅助组[(258.0±48.6)ml、(6.5±1.2)分],差异均有统计学意义(江3.75、12.96,均P<0.05)。全胸腔镜组患者术后生存质量评分[总分(88.7±9.6)分]高于胸腔镜辅助组[总分(71.1±8.2)分],差异有统计学意义(t=9.1,P<0.05)。两组患者术后无瘤生存时间比较差异无统计学意义(P>0.05)。结论全胸腔镜手术治疗Ⅰ期非小细胞肺癌的近、远期疗效均较好,值得推广应用。Objective To compare the clinical efficacy of video-assisted thoracoscopic surgery with video-assisted minithoracotomy for stage Ⅰ non-small cell lung cancer. Methods Eighty six patients with stage Ⅰ non-small cell lung cancer were randomly assigned in two groups： 46 cases underwent video-assisted thoracoscopic surgery （study group） and 40 cases received video-assisted minithoracotomy （control group）. The surgical procedures, postoperative quality of life and cancer-free survival time were compared between two groups. Results There were no significant differences in operative time, intraoperative blood loss, postoperative thoracic tube placement time and length of hospital stay between two groups （P 〉0.05）. The volume of pleural fluid drainage was less in study group than that in control group （217.8 ± 50.5ml vs 258.0 ± 48.6ml, P〈0.05） and VAS score in study group was lower than that in study group （3.9 ± 0.6ml vs. 6.5 ± 1.2ml, P〈0.05）. The postoperative quality of life score in study group was higher than that in control group （88.7 ±9.6 vs. 71.1 ±8.2, P〈0.05）. There was no significant difference in cancer-free survival time between two groups （P 〉0.05）. Conclusion The short and long-term outcomes of video-assisted thoracoscopic surgery are satisfactory for patients with stage I non-small cell lung cancer.

关 键 词：全胸腔镜手术 胸腔镜辅助小切口手术 非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤]