VATS与开胸肺癌根治术治疗Ⅰ期非小细胞肺癌近期效果比较  

A comparative analysis of VATS with thoracotomy for patients with stageⅠNSCLC

作　　者：侯伟[1] 李佳[1] 高小见[1] 

机构地区：[1]枣阳市第一人民医院胸外科,湖北枣阳441200

出　　处：《现代肿瘤医学》2017年第3期371-374,共4页Journal of Modern Oncology

摘　　要：目的:对比分析电视辅助胸腔镜手术(video-assisted thoracic surgery,VATS)与开胸肺癌根治术对Ⅰ期非小细胞肺癌(NSCLC)的临床近期疗效。方法:选择Ⅰ期NSCLC 75例,分为VATS组(n=36)和开胸组(n=39),对两组手术、实验室、生活质量指标进行比较。结果:术中出血量、引流量、术后首次下床时间、术后住院时间:胸腔镜组为(102±28.9)ml、(254±56.3)ml、(2±0.8)d、(10±2.3)d明显低于开胸组(174±25.7)ml、(405±46.8)ml、(4±0.9)d、(13±1.7)d,差异有统计学意义(P<0.05)。淋巴结清扫、术后复发、转移两组无明显差异(P>0.05)。超敏C反应蛋白两组均较术前增高,而胸腔镜组术后3d(9.32±1.75)mg/L明显低于开胸组(10.57±2.25)mg/L(P<0.05)。两组FEV1均较术前降低,但胸腔镜组(1.67±0.14)L/min明显高于开胸组(1.59±0.18)L/min(P<0.05)。两组术后生活质量得分均较术前高,但胸腔镜组(117.6±6.43)分明显高于开胸组(113.2±4.83)分(P<0.05)。结论:VATS治疗Ⅰ期NSCLC创伤小,术后生活质量高于常规开胸术。Objective： To compare the early clinical effects of patients with stage I NSCLC treated by VATS and thoracotomy. Methods：Totally 75 cases of NSCLC in stage I were randomly divided into two groups：VATS group （n = 36） and thoracotomy group （n = 39 ）. The operative index, laboratory parameters and quality of life were observed. Results： Blood loss,chest tube drainage,postoperative ambulation first time, postoperative hospital stay in the VATS group were （ 102 ±28. 9） ml, （254 ±56. 3） ml, （2 ±0. 8）d , （10 ±2. 3）d significantly lower than those （ 174 ±25. 7） ml,（405 ±46.8） ml,（4 ±0. 9）d,（13 ±1.7）d of thoracotomy group （ P 〈 0. 05 ）. There was no difference of lymph node dissection and postoperative recurrence between the two groups （P 〉 0 .0 5 ） . The blood amount of high - sensi-tivity C - reactive protein was （9.32 ±1.75）mg/L on the 3rd postoperative day in the VATS significantly lower than that of thoracotomy group （ 10. 57 ± 2. 25 ） mg/L,P 〈 0. 05. After surgery 1 , 3,6 months,the FEV1 of patients was （1.67 ± 0. 14） L/min in ＂VATS group significantly higher than thoracotomy group （ 1.59 ± 0. 18 ） L/min （ P 〈 0. 05 ）. The score of postoperative quality of life was 117.6 ±6.43 in VATS group significantly higher than 113. 2 ±4. 83 in the thoracoscopic group （P 〈0.05）. Conclusion： VATS is superio to thoraocotomy for stage INSCLC with minimum injury and better post operative quality of life.

关 键 词：VATS 肺癌根治术 NSCLC 生活质量 

分 类 号：R730.5[医药卫生—肿瘤] R734.2[医药卫生—临床医学]