肺叶切除术和局限性切除术治疗早期老年非小细胞肺癌的疗效评价  

Therapeutic evaluation of complete pulmonary lobectomy versus limited resection in the treatment for early-stage non-small cell lung cancer in the elderly

作　　者：刘勉[1] 邸茹杰[1] 高敏[2] 

机构地区：[1]武警总医院首保临床部,北京100039 [2]武警总医院质量管理科,北京100039

出　　处：《武警后勤学院学报（医学版）》2017年第9期766-769,共4页Journal of Logistics University of PAP（Medical Sciences）

摘　　要：【目的】探讨肺叶切除术和局限性切除术治疗早期老年非小细胞肺癌的安全性和可行性,评价其手术疗效。【方法】2011年5月至2013年9月在我院实施手术治疗的185例早期老年非小细胞肺癌患者,分为肺叶切除术组(n=107)和局限性切除术组(n=78),回顾性比较分析其围手术期相关资料及生存数据。【结果】肺叶切除术组与局限性切除术组患者比较手术时间(125.6min vs.102.3 min)、术中出血量(115.3 ml vs.72.5 ml)、胸导管引流时间(6.5 d vs 4.2 d)、手术后住院时间(10.8 d vs.8.6 d)、淋巴结切除量(12.5枚vs.8.6枚)两两比较,差异均有统计学意义(P<0.05);两组患者术后肺部感染发生率和并发症比较,差异无统计学意义,(P>0.05)。肺叶切除术组与局限性切除术组患者比较,术后3年局部复发率比较(7.5%vs 11.5%),差异无统计学意义(P>0.05);两组术后1年、2年、3年生存率比较,差异无统计学意义(P>0.05)。【结论】局限性切除术具有手术时间和引流时间短、出血量少、手术创伤小、术后住院时间短等优势,近期生存率满意,可作为治疗早期老年非小细胞肺癌的优先选择。[ Objective ] To investigate the safety and feasibility of complete pulmonary lobectomy and limited resection in the treatment of early-stage non-small cell lung cancer in the elderly, and evaluate the therapeutic efficacy. [Methods] From May 2011 to September 2013, 185 elderly patients with early-stage non-small-cell lung cancer undergoing the surgical treatment in our hospital were divided into the lobectomy group （n = 107） and the limited-resection group （n = 78）, The perioperative and survival data were analyzed retrospectively. [ Results ] Compared to limited resection for patients, The operation time, intraoperative blood loss, thoracic duct drainage time, postoperative hospital-stay time and the number of clean-up lymph nodes in the lobectomy group and limited- resection group were as follows： 125.6 min vs. 102.3 min, 115.3 ml vs. 72.5 ml, 6.5 d vs 4.2 d, 10.8 d vs 8.6 d, and 12.5 vs. 8.6, and the difference was statistically significant （P〈0.05）. There was no significant difference in the incidence of postoperative pulmonary infection and complications between the two groups （P〉0.05）. There was no significant difference in local recurrence rate 3 years after operation between the two groups （7.5% vs 11.5%） （P＇〉 0.05）. Moreover, there was no significant difference in the 1-year, 2-year and 3-year survival rates between the two groups （P〉 0.05）. [Conclusion ] The limited resection has the advantages of short operation time and drainage time, less bleeding, small surgical trauma and short postoperative hospital-stay time. Its short-term survival rate is satisfactory. Therefore, it can be the priority choice in the treatment of early-stage non-small cell lung cancer in the elderly.

关 键 词：早期 老年 非小细胞肺癌 肺叶切除术 局限性切除术 

分 类 号：R734.2[医药卫生—肿瘤]