胸腔镜肺段切除及胸腔镜辅助小切口、胸腔镜肺叶切除治疗早期肺癌的临床观察  

Clinical observation on thoracoscopic pulmonary segment resection and thoracoscopic assisted small incision and thoracoscopic lobectomy for treating early lung cancer

作　　者：程鹏[1] 于在诚[1] 谢琳琳[2] 

机构地区：[1]安徽医科大学第一附属医院普胸外科,合肥230022 [2]安徽医学高等专科学校,合肥230601

出　　处：《重庆医学》2018年第6期760-762,766,共4页Chongqing medicine

基　　金：安徽高校自然科学重点研究项目(KJ2017A699)

摘　　要：目的探讨胸腔镜不同手术方式治疗早期肺癌的临床效果。方法选取120例早期肺癌手术患者作为研究对象,根据手术方法分为胸腔镜辅助小切口肺叶切除(A组)38例,胸腔镜肺叶切除(B组)42例,胸腔镜肺段切除(C组)40例,分别比较三组患者的围术期指标、肺功能恢复情况、并发症发生率及预后。结果 B、C组在围术期指标较A组均降低(P<0.05),C组术后胸腔引流量低于B组(P<0.05);A组术后肺功能指标低于B组和C组(P<0.05),而C组肺功能指标又高于B组(P<0.05);B、C组在术后并发症发生率低于A组,差异有统计学意义(P<0.05);三组患者中位随访时间为15个月(12~18个月),均未发现复发和转移情况。结论在早期肺癌治疗中,胸腔镜肺段切除较肺叶切除能减少术后胸腔渗出,更好地保护肺功能,且生存预后无明显差异,临床疗效值得肯定。Objective To explore the clinical effect of different thoraeoscopic operation modes in the treatment of early lung cancer. Methods One hundred and twenty cases of early lung cancer surgery were selected as the research subjects and divided into 38 cases of thoracoscopic assisted small incision lobectomy group （group A） ,42 cases of thoracoscopic lobectomy （group B） and 40 cases of thoracoscopic lung segment resection （group C）. Then the perioperative indicators, lung function recovery, complications occurrence rate and prognosis were compared among 3 groups. Results The perioperative indicators in the group B and C were de- creased compared with the group A （P〈0.05）, the postoperative pleura1 drainage amount in the group C was lower than that in the group B （P〈0.05）. The postoperative lung function indexes in the group A were lower than those in the group B and C （P〈0.05） ,while the lung function indicators in the group C were higher than those in the group B （P〈0.05）. The incidence rate of postoperative complications in the group B and C was lower than that in the group A, the difference was statistically significant （P〈0.05）;the median follow up period in the three groups was 15 months（12--18 months）. No recurrence or metastasis was found. Conclusion For the treatment of early lung cancer, the thoracoscopic lung segment resection can reduce postoperative pleural effusion and better protect pulmonary function,moreover the survival and prognosis have no obvious difference and its clinical curative effect is worth to be affirmed.

关 键 词：胸腔镜 肺肿瘤 肺功能 肺叶切除 肺段切除 

分 类 号：R615[医药卫生—外科学]