胸腺肽联合胸腔镜根治术治疗老年早期肺癌患者的疗效及生存分析  

Efficacy and survival analysis of thymosin combined with thoracoscopic radical resection in the treatment of elderly patients with early lung cancer

作　　者：王凯[1] 宋巍 陈伟光[1] 姜永日[1] WANG Kai;SONG Wei;CHEN Weiguang;JIANG Yongri(Department of Cardiac Surgery, the Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang, China)

机构地区：[1]哈尔滨医科大学附属第四医院心外科,哈尔滨150001

出　　处：《癌症进展》2019年第4期423-426,共4页Oncology Progress

摘　　要：目的研究胸腺肽联合胸腔镜根治术对老年早期肺癌患者的疗效及生存期的影响。方法选取136例老年早期肺癌患者,根据手术方法不同将患者分为观察组和对照组,每组68例,观察组采用胸腺肽联合胸腔镜手术,对照组采用传统开胸手术,观察比较两组患者围手术期指标、免疫细胞水平以及生存率、复发率、不良反应发生率。结果观察组患者手术时间、拔除引流管时间、术后下床时间及住院时间均明显短于对照组患者,手术出血量明显少于对照组患者,差异均有统计学意义(P﹤0.01)。手术前,两组患者免疫细胞CD4^+、CD8^+、CD4^+/CD8^+、CD3^+、自然杀伤细胞(NK)水平比较,差异均无统计学意义(P﹥0.05);手术后,两组患者免疫细胞CD4^+、CD8^+、CD4^+/CD8^+、CD3^+、NK水平均较本组手术前下降,且对照组患者CD4^+、CD8^+、CD4^+/CD8^+、CD3^+、NK水平均低于观察组,差异均有统计学意义(P﹤0.05)。观察组患者1年、2年、3年生存率均明显高于对照组,差异均有统计学意义(P﹤0.01);观察组患者复发率低于对照组,差异有统计学意义(P﹤0.05)。观察组患者治疗后总不良反应发生率低于对照组,差异有统计学意义(P﹤0.05)。结论胸腺肽联合胸腔镜手术治疗老年早期肺癌患者临床疗效显著,患者出血量少,免疫细胞水平波动较小,生存率高,值得临床推广应用。Objective To observe the effect of thymosin combined with thoracoscopic surgery on curative effect and survival time of elderly patients with early stage lung cancer after radical operation. Method A total of 136 elderly patients with early stage lung cancer who underwent surgery were included in the research as study group and control group, with 68 cases in each, respectively, patients in study group were administered with thymosin combined with thoracoscopic surgery, while those in the control group were given traditional thoracotomy, the perioperative operative factors, level of immune cells, survival rate, recurrence rate and the incidence of adverse reactions were observed and compared between the two groups. Result The operative time, time of chest tube removal, time to postoperative ambulation, and length of stay in hospital were shorter in study group than those in control group, in addition, patients in study group had less intraoperative blood loss compared with control group (P<0.01);before surgery, there were no significant differences between the two groups of patients in regard with level of CD4^+, CD8^+, CD4^+/CD8^+, CD3^+, and NK cells (P>0.05);after surgery, the level of immune cells above decreased in both groups, and those in control group were significantly lower than that in study group (P<0.05). The 1-, 2-, and 3-year survival rates were significantly higher in study group than in control group (P<0.01);as for the recurrence, lower rate was observed in study group compared with control group (P< 0.05). Additionally, the study group showed lower overall incidence of adverse reactions than that in control group, with statistically significant difference observed (P<0.05). Conclusion Thymosin combined with thoracoscopic surgery for elderly patients with early stage lung cancer receiving radical resection is clinically effective, with less blood loss, minor fluctuation of immune cell level, and higher survival rate, which is clinically applicable.

关 键 词：胸腺肽 胸腔镜手术 老年早期肺癌 根治术 免疫功能 生存期 

分 类 号：R734.2[医药卫生—肿瘤]