全胸腔镜肺叶切除术治疗早期非小细胞肺癌的临床效果  

Study on Clinical Effect of Video Thoracoscope Lobectomy for Early Stage Non-small Cell Lung Cancer

作　　者：李喆[1] 杨杨[1] 刘延风[1] 许瑞彬[1] 李伟伟 

机构地区：[1]延安大学附属医院,716000

出　　处：《实用癌症杂志》2018年第1期82-85,共4页The Practical Journal of Cancer

摘　　要：目的分析全胸腔镜肺叶切除术治疗早期非小细胞肺癌的近、远期临床疗效,为临床早期肺癌的治疗方案选择提供参考。方法选择Ⅰ期非小细胞肺癌患者86例作为研究对象,根据就诊顺序编号,采用数字随机表法将其分为对照组和观察组,每组43例。对照组患者采用小切口开胸肺叶切除术治疗,观察组采用全胸腔镜肺叶切除术治疗。比较两组患者手术相关指标(手术时间、出血量、术后排气时间、术后引流量、术后并发症、术后感染率),术后3、6个月免疫功能指标(CD_3^+、CD_4^+、CD_8^+、CD_4^+/CD_8^+)、术后6、12个月肿瘤患者共性生活质量核心量表QLQ-C30评分、术后1、3年生存期及肿瘤复发率。结果观察组患者手术时间、术中出血量、术后排气时间、术后引流量、术后并发症发生率及术后感染率均优于对照组,组间比较差异有统计学意义(P<0.05)。术前两组患者CD_3^+、CD_4^+、CD_8^+、CD_4^+/CD_8^+值比较,差异均无统计学意义,术后3、6个月,两组患者CD3+值均较术前升高,CD_4^+、CD_8^+、CD_4^+/CD_8^+值均较术前有所降低(P<0.05),术后3、6个月观察组患者CD3+值均低于对照组,CD_4^+、CD_8^+、CD_4^+/CD_8^+值均高于对照组,差异有统计学意义(P<0.05)。观察组患者术后6个月、12个月共性生活质量核心量表QLQ-C30评分均明显高于对照组(P<0.05)。术后1、3年生存期及肿瘤复发率两组比较差异无统计学意义(P>0.05。结论全胸腔镜肺叶切除术较之于小切口开胸肺叶切除术治疗早期非小细胞肺癌患者,虽然不能提高患者的生存期和1、3年生存率,降低复发率,但对于提升患者术后免疫功能、生活质量具有较高的临床价值。Objective To analyze the clinical effect of video thoracoscope Lobectomy for early stage non-small cell lung cancer, and to provide reference for the clinical treatment of early lung cancer. Methods 86 cases of non-small cell lung cancer patients, according to the treatment sequence number,were randomly divided into the control group and the observation group ,43 cases in each group. The control group were treated by small incision thoracotomy lobeetomy, the observation group adopted thora- eoseopic lobectomy. The related indexes were compared between the 2 groups （ surgical operation time, bleeding volume, postoper- ative exhaust time, postoperative drainage, postoperative complications, postoperative infection rate 3 months and 6 months after surgery ） , immune function （CD3＋ , CD4＋ , CD8＋ , CD4＋/CD8＋ ）, common cancer patients the core quality of life scale QLQ-C30 score 6 months and 12 months after surgery, 1-,3-year tumor recurrence rates and survival prediction after operation. Results Operation time, intraoperative bleeding volume, postoperative exhaust time, postoperative drainage, postoperative complication rate and postoperative infection rate of the observation group were lower than the control group, there were significant differences be- tween the 2 groups （P 〈 0.05） ;full thoracoscopic lobectomy for patients with less injury, to patients after operation recovery. At 3 months and 6 months after operation, the patients in the observation group were significantly lower than those of the control group, CD4 ＋ ,CD8＋ and CD4 ＋/CD8＋ were significantly higher than those of the control group （P 〈0.05）. In the observation group,6 months and 12 months after operation,the QLQ-C30 score of the common quality of life of cancer patients was significantly higher than that of the control group （ P 〈 0.05 ）. 1- ,3-year tumor recurrence rate and survival of 2 groups had no statistically significant difference. Conclusion Compared with small incision thoracotomy lobectomy, thor

关 键 词：早期非小细胞肺癌 全胸腔镜肺叶切除术 小切口开胸肺叶切除术 临床疗效 

分 类 号：R734.2[医药卫生—肿瘤]