电视胸腔镜治疗非小细胞肺癌的疗效及影响因素  

Curative effect and its influence factors of video-assisted thoracoscope treatment in non-small cell lung cancer

作　　者：孟祥宽[1] 孙振宇[1] 罗静娴[1] 范伟[1] 叶广华[1] 

机构地区：[1]北京市仁和医院,北京102600

出　　处：《临床肺科杂志》2016年第11期2067-2070,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的：研究电视胸腔镜治疗非小细胞肺癌的疗效及其影响因素。方法选取本院2013年4月-2015年4月收治90例原发性非小细胞肺癌患者作为研究对象,随机分为对照组和观察组各45例患者。观察组使用胸腔镜辅助下小切口肺叶切除术,对照组采用传统的开胸肺叶切除术。再采取Log-rank 检验和Kaplan-Meier法估计两组患者的中位生存时间和生存率,采用Cox 比例风险回归模型分析胸腔镜微创治疗效果的影响因素。结果两组患者的总体生存时间分布之间无显著性差异（χ2=0．335,P=0．846）；患者的肿瘤分期（χ2=46．593,P〈0．001）与患者的预后之间的关系密切,而患者的年龄（χ2=1．229,P=0．268）、性别（χ2=0．389,P=0．533）和吸烟史（χ2=1．491,P=0．222）与患者的预后之间没有直接联系；患者清扫的淋巴结个数和肿瘤分期是影响非小细胞肺癌患者治疗的独立因子。而组织分化、是否辅助化疗、病灶长度以及支气管切缘的情况是影响非小细胞肺癌患者治疗的非独立因子,考虑这些因素协同作用对患者疗效的影响。结论使用电视胸腔镜治疗非小细胞肺癌和传统的手术方法疗效差异不大,且肿瘤分期和淋巴结的清扫个数是影响患者预后的独立因素。Objective To analyze the curative effect and its influence factors of video-assisted thoracoscope treatment in non-small cell lung cancer. Methods We selected 90 cases of primary non-small cell lung cancerpatients as the research objects, and they were randomly divided into the control group and the observation group. Each group had 45 cases patients. It used traditional thoracotomy lung resection in the control group, and lung resec-tion of thoracoscope assisted small incision in the observation group. Results There was no significant difference in overall survival time between the two groups （χ2 =0. 335, P=0. 846）. There was close relationship between cancer stage and prognosis of patients （χ2 =46. 593, P〈0. 001）. But there were no direct link between the prognosis of pa-tients with age （χ2 =1. 229, P =0. 268）, gender （χ2 =0. 389, P =0. 533） and smoking （χ2 =1. 491, P =0. 222）. The number of cleaning lymph nodes and tumor staging were the independent factors of NSCLC patients. Conclusion The curative effect of video-assisted thoracoscope treatment and traditional surgical method for non-small cell lung cancer has no significant difference, and tumor stages and the number of lymph node cleaning are the independent factors influencing their prognosis.

关 键 词：非小细胞型肺癌 胸腔镜手术 多因素分析 

分 类 号：R734.2[医药卫生—肿瘤]