胸腔镜辅助小切口手术与传统开胸术在中心型非小细胞肺癌治疗中的应用分析  

Application analysis of thoracoscopic assisted small incision surgery and traditional thoracotomy in the treatment of central non-small cell lung cancer

作　　者：华克胜[1] 侯亚莉[2] HUA Ke-sheng;HOU Ya-li(Department of Thoracic Surgery,Shandong Heze Municipal Hospital,Heze 274000,China)

机构地区：[1]山东菏泽市立医院胸外科,274000 [2]山东菏泽医学专科学校,274000

出　　处：《中国实用医药》2018年第23期3-5,共3页China Practical Medicine

摘　　要：目的比较胸腔镜辅助小切口手术与传统开胸术在中心型非小细胞肺癌治疗中的价值。方法 72例中心型非小细胞肺癌患者,根据手术方案不同分为A组和B组,每组36例。A组行传统开胸肺癌根治术,B组在电视胸腔镜辅助小切口下行肺癌根治术,比较两组患者的淋巴结清扫数目、手术相关指标、术后并发症发生情况、术后48 h疼痛情况。结果两组的淋巴结清扫数目和手术时间比较差异均无统计学意义(P>0.05);B组术中出血量、术后引流管留置时间、术后住院时间均少于A组,差异均具有统计学意义(P<0.05)。B组的并发症发生率为8.33%(3/36),明显低于A组的27.78%(10/36),差异具有统计学意义(χ2=4.600,P=0.032<0.05)。B组患者Ⅰ度疼痛发生率30.56%(11/36)显著高于A组的5.56%(2/36),差异具有统计学意义(χ2=7.604,P=0.006<0.05)。结论胸腔镜辅助小切口术与传统开胸术在中心型非小细胞肺癌治疗中清扫淋巴结的效果相当,但胸腔镜辅助小切口术具有创伤小、并发症少、术后疼痛轻、恢复快等优点,故该术式可以替代传统开胸手术,成为中心型非小细胞肺癌治疗的常规方法。Objective To compare the value of thoracoscopic assisted small incision surgery and traditional thoracotomy in the treatment of central non-small cell lung cancer. Methods A total of 72 cases of central non-small cell lung cancer were divided into group A and group B according to the different surgical procedures, 36 cases in each group. Group A was treated with traditional thoracotomy lung cancer resection, group B was treated with video-assisted thoracoscopic resection of small incision lung cancer. The number of lymph node dissection, operative related indicators, postoperative complications and postoperative pain at 48 h between the two groups were compared. Results There were no statistically significant differences in the number of lymph node dissection and operative time between the two groups（P〈0.05）. The bleeding volume, postoperative drainage tube retention time and postoperative hospital stay in the group B were significantly less than those in the group A, the differences were statistically significant（P〈0.05）. The incidence of complications in the group B was 8.33%（3/36）, which was significantly lower than 27.78%（10/36） in the group A, the difference was statistically significant（χ2=4.600, P=0.0320.05）. The incidence of grade Ⅰ pain in the group B was 30.56%（11/36）, which was significantly higher than 5.56%（2/36） in the group A, the difference was statistically significant（χ2=7.604, P=0.0060.05）. Conclusion Thoracoscopic assisted small incision surgery and traditional thoracotomy are effective in clearing lymph nodes in the treatment of central non-small-cell lung cancer, but thoracoscopic assisted small incision surgery has the advantages of less trauma, fewer complications, less postoperative pain and quicker recovery. Therefore, it can replace traditional thoracotomy and become a conventional method for central non-small cell lung cancer.

关 键 词：中心型非小细胞肺癌 胸腔镜辅助小切口手术 传统开胸术 

分 类 号：R734.2[医药卫生—肿瘤]