单孔全胸腔镜下肺叶切除治疗周围型非小细胞肺癌的安全性和有效性  

Safety and efficacy of single port thoracoscopic lobectomy on treatment of peripheral non-small cell lung cancer

作　　者：王继振[1] 刘公哲 李大宏[1] Wang Jizhen;Liu Gongzhe;Li Dahong(Department of Cardiothoracic Surgery,Laiwu People＇s Hospital,Shandong Laiwu 271100,China.)

机构地区：[1]莱芜市人民医院胸心外科,山东莱芜271100

出　　处：《现代肿瘤医学》2018年第10期1544-1547,共4页Journal of Modern Oncology

基　　金：山东省卫生和计划委员会自然科技计划项目(编号:KJ201503004)

摘　　要：目的:探讨单孔全胸腔镜下肺叶切除治疗周围型非小细胞肺癌的安全性和有效性。方法:自2016年1月至2017年1月,前瞻性收集我院收治的周围型非小细胞肺癌患者94例,随机分为观察组和对照组,每组各47例。观察组采用单孔胸腔镜治疗,对照组采用多孔胸腔镜治疗。比较两组患者手术情况、术后应激反应、术后康复情况和术后并发症。结果:两组患者术前应激激素血管紧张素(AngⅡ)和C-反应蛋白(CRP)比较差异均无统计学差异(P>0.05)。术后72 h,与对照组比较,观察组患者AngⅡ显著降低[(69.49±15.92)vs(82.91±17.53)pg/ml,P=0.000];CRP也显著降低[(12.92±3.65)vs(14.62±3.84)mg/L,P=0.030]。与对照组比较,观察组患者肛门排气时间显著缩短[(64.55±9.65)vs(70.71±9.93)h,P=0.003];住院时间显著缩短[(10.81±1.78)vs(11.95±1.79)d,P=0.003];引流时间显著缩短[(63.87±12.92)vs(70.12±13.85)h,P=0.026]。与对照组比较,观察组患者手术时间显著延长[(183.57±26.95)vs(171.87±28.14)min,P=0.042]。两组患者术后并发症比较差异无统计学意义(P>0.05)。结论:单孔全胸腔镜下肺叶切除治疗周围型非小细胞肺癌虽轻度延长手术时间,但可降低患者术后应激反应,加速术后康复。Objective：To evaluate the safety and efficacy of single port thoracoscopic lobectomy on treatment of peripheral non-small cell lung cancer.Methods：From January 2016 to January 2017,we prospectively collected 94 cases of peripheral non-small cell lung cancer in our hospital.They were randomly divided into an observation group and a control group,47 cases in each group.The patients in the observation group were treated by single port thoracoscopy,while the control group was treated with porous thoracoscopy.The operation condition,postoperative stress reaction,postoperative rehabilitation and postoperative complications were compared between the two groups.Results：There were no significant differences between the two groups in preoperative AngⅡ and CRP（P〉0.05）.After 72 h,when compared with the control group,both the AngⅡ and CRP decreased significantly[（69.49±15.92） vs （82.91±17.53） pg/ml,P=0.000] and [（12.92±3.65） vs （14.62±3.84） mg/L,P=0.030].When compared with the control group,the observation group got a shorter anal exhaust time[（64.55±9.65） vs （70.71±9.93） h,P=0.003] and a shorter hospital duration[（10.81±1.78） vs （11.95±1.79） d,P=0.003].Moreover,the drainage time of the observation group was apparently shorter than that of the control group[（63.87±12.92） vs （70.12±13.85） h,P=0.026].However,the operation time of the observation group was longer than that of the control group[（183.57±26.95） vs （171.87±28.14） min,P=0.042].There were no significant differences between the two groups in postoperative complications（P〉0.05）.Conclusion：Single port thoracoscopic lobectomy prolong the operation time in patients with peripheral non-small cell lung cancer,but it can reduce the postoperative stress response and accelerate postoperative rehabilitation.

关 键 词：单孔全胸腔镜 非小细胞肺癌 肺叶切除 应激反应 

分 类 号：R734.2[医药卫生—肿瘤]