胸腔镜肺段切除治疗早期非小细胞肺癌的疗效及对心肺功能的影响  

Effect of Thoracoscopic Segmentectomy on Early Stage Non-small Cell Lung Cancer and its Influence on Cardiopulmonary Function

作　　者：李传海[1] 莫修鑫 孙之昀 杜以营 邹志强[1] LI Chuanhai;MO Xiuxin;SUN Zhiyun(General Hospital of Jinan Military Area,Shandong Ji'nan 250031,China)

机构地区：[1]济南军区总医院胸外科,山东济南250031

出　　处：《河北医学》2018年第7期1139-1144,共6页Hebei Medicine

基　　金：山东省科技计划项目;(编号:2011K027)

摘　　要：目的:观察胸腔镜肺段切除治疗早期非小细胞肺癌的疗效及对心肺功能的影响,评价其临床应用价值。方法:回顾性分析2015年6月至2017年9月就诊的早期非小细胞肺癌患者62例,接受胸腔镜下肺叶切除的31例作为常规组,接受胸腔镜肺段切除治疗的31例作为研究组,分析比较两组围手术期情况、术中淋巴结清扫、手术前后心肺功能、术后并发症情况、复发情况及1年生存率情况。结果:研究组手术时间较常规组手术时间长(P<0.05),但是研究组术中出血量、伤口引流量、住院时间、镇痛药使用剂量均少于常规组(P<0.05);两组患者总淋巴结清扫数量、纵隔淋巴结清扫数量比较无统计学意义(P>0.05),但是研究组术后总并发症发生率较常规组少(P<0.05);两组手术前用力呼气肺活量(FVC)、1s用力呼气容量(FEV1)、最大通气量(MVV)无差异(P>0.05),手术后两组患者FVC、FEV1、MVV均增加(P<0.05),且手术后研究组FVC、FEV1、MVV增加水平大于常规组(P<0.05);两组手术前心率(HR)、每分钟搏出量(SV)、左心射血分数(LVEF)无差异(P>0.05),手术后两组患者HR均有所下降(P<0.05),SV、LVEF均增加(P<0.05),且手术后研究组HR下降水平大于常规组(P<0.05),研究组SV、LVE增加水平大于常规组(P<0.05);两组患者术后均有不同程度复发,但是两组患者复发无差异(P>0.05),研究组术后1年生存率高于研究组(P<0.05)。结论:胸腔镜肺段切除治疗早期非小细胞肺癌疗效确切,可减少术中出血量、缩短住院时间,减轻患者疼痛,并减少术后镇痛剂用量,术后并发症少,可有效改善心肺功能,且术后1年生存率较高,值得临床推广。Objective:To observe the effect of thoracoscopic segmentectomy for the treatment of early stage non-small cell lung cancer and its influence on cardiopulmonary function and evaluate its clinical value.Methods:Retrospective analysis 62 cases of patients with early-stage non-small cell lung cancer treated in our hospital from June 2015 to September 2017,31 patients who received thoracoscopic lobectomy were as the routine group,31 patients who received thoracoscopic segmentectomy were as the research group.The peri-operative period,intraoperative lymph node dissection,cardiac and pulmonary function before and after operation,postoperative complications,recurrence and the 1 year survival rate were analyzed and compared between the two groups.Results:The operation time of the study group was longer than that of the conventional group(P<0.05).However,the amount of bleeding,wound drainage,hospitalization time and dosage of analgesics in the study group were all lower than those in the conventional group(P<0.05).There was no significant difference in the number of total lymph node dissection and mediastinal lymph node dissection between the two groups(P>0.05).However,the incidence of postoperative complications was less than that of the conventional group(P<0.05);The forced expiratory volume(FVC),forced expiratory volume(FEV1)and maximum ventilation(MVV)in two groups before surgery were not significantly different between the two groups(P>0.05),after operation,FVC,FEV1 and MVV in both groups were increased(P<0.05),and the levels of FVC,FEV1 and MVV in the postoperative operation group were higher than those in the conventional group(P<0.05);Preoperative heart rate(HR),stroke volume per minute(SV),left ventricular ejection fraction(LVEF)no difference(P>0.05),after operation,the HR of both groups decreased(P<0.05),and the levels of SV and LVEF increased(P<0.05),the HR of the study group after surgery was significantly lower than that of the conventional group(P<0.05),study group SV,LVE increased more than the conventional

关 键 词：胸腔镜肺段切除 早期 非小细胞肺癌 心肺功能 

分 类 号：R734.2[医药卫生—肿瘤]