胸腔镜下肺叶切除术和肺段切除术治疗肺癌患者临床疗效及其对肺功能影响的比较  

The comparison of the clinical efficicy and lung function of thoracoscopic pulmonary lobectomy and pulmonary segmentectomy in patients with lung cancer

作　　者：赵晓龙[1] 孟胜蓝[1] 蔡云婷[1] 牛会军[1] 

机构地区：[1]第三军医大学大坪医院胸外科,重庆400042

出　　处：《疑难病杂志》2016年第7期690-693,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的比较胸腔镜下肺叶切除术和肺段切除术对肺癌患者的效果及其对肺功能的影响。方法选取2013年10月—2015年10月第三军医大学大坪医院胸外科收治的早期肺癌患者58例为研究对象,术前均行全身PETCT检查,排除远端转移。按照胸腔镜下手术切除范围分为肺段切除组29例和肺叶切除组29例,均采用两孔法,分别采用肺段切除术和肺叶切除术治疗。比较2组患者术中出血量、胸腔引流量、手术时间、淋巴清扫数量、术后住院时间、胸腔引流管留置时间,肺功能(FEV_1、FVC)变化、疼痛评分和并发症发生情况。结果肺段切除组在术中出血量、胸腔引流量、手术时间及术后第1、3、7d疼痛评分均显著低于肺叶切除组(t=8.047、1.744、1.759、4.393、4.560、3.741,P<0.05、P<0.01),2组患者在术后淋巴清扫数量、术后住院时间及胸腔引流管留置时间比较,差异均无统计学意义(t=0.453、0.230、0.363,P>0.05);2组患者术后FEV_1、FVC水平较治疗前均明显降低(肺段切除组:t=6.072、5.338,P<0.05;肺叶切除组:t=10.146、10.499,P<0.01),其中肺段切除组较肺叶切除组肺功能损伤更小(t=4.972、5.475,P<0.01);2组并发症发生情况比较差异无统计学意义(P>0.05)。结论胸腔镜下肺叶切除术和肺段切除术均安全可行,手术创伤小,术后恢复快,并发症少,且肺段切除术更有利于保护患者肺功能。Objective To compare the clinical efficacies of thoracoscopic pulmonary lobectomy and segmentectomy in treating patients with lung cancer and the influence on lung function.Methods Fifty-eight cases of patients with early stage lung cancer were enrolled,which were treated in the hospital from October 2013 to October 2015,and were divided into the segmentectomy group（29 cases） and lobectomy group（29 cases） according to thoracoscopic resection range.The patients of two groups were treated with urine,blood,liver and kidney function,blood coagulation,tumor markers,PETCT examination and other routine checks,to exclude distant metastases before surgery.The patients of two groups were respectively treated with segmentectomy and lobectomy,which were all two holes.The blood loss,pleural drainage,operative time,the number of lymph nodes resection,postoperative hospital stay,chest tube indwelling time,lung function（FEV_1,FVC） changes and pain scores and the incidence of complications of patients in both groups were compared.Results The blood loss,pleural drainage,operative time,pain scores on the 1st,3rd,and 7th day after operation of the segmentectomy group was significantly lower than those of the lobectomy group（t =8.047,1.744,1.759,4.393,4.560,3.741,P 0.05,P 0.01）.In terms of the number of lymph node resection,postoperative hospital stay and chest tube indwelling time,there was no significant difference between the two groups（t = 0.453,0.230,0.363,P 0.05）;In terms of FEV,and FVC levels,the patients of two groups were all significantly decreased than before（The segmentectomy group：t =6.072,5.338,P 0.05;The lobectomy group;t = 10.146,10.499,P 0.05）,and the lung founction injury the segmentectomy group was smaller than the lobectomy group（t = 4.972,5.475,P 0.05）;The incidence of complications revealed no significant difference between the two groups（χ~2=0.075,0.086,0.195,0.086,0.301,0.075,0.485,P 0.05）.Conclusion Thoracoscopic pulmonary lobectomy and pulmonary segmentectomy are all safe a

关 键 词：肺癌 肺叶切除术 肺段切除术 肺功能 

分 类 号：R734.2[医药卫生—肿瘤]