胸腔镜下肺叶切除术治疗肺癌的围术期应激反应及疗效观察  

Efficacy and perioperative stress reactions of thoracoscopic lobectomy in patients with lung cancer

作　　者：张颖博[1] 

机构地区：[1]新乡市第一人民医院心胸外科,453000

出　　处：《国际医药卫生导报》2017年第12期1876-1879,共4页International Medicine and Health Guidance News

摘　　要：目的探讨胸腔镜下怖叶切除术治疗非小细胞肺癌的围术期应激反应水平及临床疗效。方法将本院2014年2月至2016年4月收治的96例非小细胞肺癌患者随机分为观察组和对照组，每组48例。观察组患者采用胸腔镜下肺叶切除术治疗，对照组患者采用传统开胸肺叶切除术治疗。比较两组患者的手术-般指标、同术期血清炎性因子及并发症的差异。结果两组患者手术成功率均为100％，但观察组患者术中出血量、术后引流时间及术后VAS评分[（135．88±12．77）ml、（3．62±1．21）d、（4．10±0．52）]明显低于对照组[（164．69±15．54）ml、（5．45±1．55）d、（5．33±0．82）1，差异有统计学意义（P〈0．05）；治疗后，观察组患者血清CRP、TNF-α、IL-6、IL-10水平分别为（36．45±8．73）mg／L、（67．68±7．66）μg/L、（211．24±11．55）μg/L、（273．55±15．27）μg/L，明显低于对照组的（44．33±10．25）mg/L、（86．42±10．29）μg/L、（234．37±24．86）μg/L、（310．26±16．29）μg/L，差异有统计学意义（P〈0．05）；观察组患者围术期内临床并发症总发生率为12．50％，明显低于对照组的31．25％，差异有统计学意义（P〈0．05）。结论相对于传统开胸肺叶切除术，胸腔镜下肺叶切除术治疗非小细胞肺癌能够有效改善患者的手术指标，减轻机体应激反应，降低血清炎性因子，且术后并发症发生率更低，具有临床推广价值。Objective To investigate the efficacy and perioperative stress reactions of thoracoscopic lobectomy in patients with lung cancer. Methods 96 patients with non small cell lung cancer in our hospital from February 2014 to April 2016 were randomly divided into observation group and control group, 48 cases in each group. The observation group was treated with thoracoscopic lobectomy, while the control group was treated with pulmonary lobectomy. Compared the differences of general surgical index, perioperative serum inflammatory factors, and postoperative complications between two groups. Results The operation success rates of the two groups were 100%, but the intraoperative blood loss, postoperative drainage time, postoperative VAS score of the observation group [（135.88±12.77）ml, （3.62±1.21）d, （4.10±0.52）] were significantly lower than those of the control group [（164.69±15.54）ml, （5.45±1.55）d, （5.33±0.82）], with statistically significant differences （P〈0.05）. The serum levels of CRP, TNF-α, IL-6, and IL-10 in the observation group after treatment were （36.45±8.73）mg/L, （67.68±7.66） μg/L, （211.24±11.55）μg/L, （273.55±15.27）μg/L, significantly lower than （44.33±10.25）mg/L, （86.42±10.29）μg/L, （234.37±24.86）μg/L, （310.26±16.29）μg/L in the control group （P〈0.05）. The total incidence of perioperative complications in the observation group was 12.50%, significantly lower than 31.25% in the control group （P〈0.05）. Conclusion Compared with traditional thoracotomy lobectomy, thoracoscopic lobectomy can effectively improve the patients＇ surgical index, reduce the stress response and serum inflammatory factors, with clinical value.

关 键 词：肺癌 胸腔镜 肺叶切除术 围术期应激反应 疗效观察 

分 类 号：R734.2[医药卫生—肿瘤]