不同手术方式治疗老年早期肺癌的近期疗效及对患者呼吸功能的影响  

The short-term effect of different surgical methods in the treatment of elderly patients with early lung cancer and its influence on respiratory function

作　　者：王虎[1] 杨冉[1] 杨博[1] WANG Hu;YANG Ran;YANG Bo(Department of Thoracic Surgery,Anyang Cancer Hospital,Anyang 455000,He’nan,China)

机构地区：[1]安阳市肿瘤医院胸外科,河南安阳455000

出　　处：《癌症进展》2020年第16期1684-1687,共4页Oncology Progress

摘　　要：目的比较胸腔镜下肺段切除、肺叶切除术及肺楔形切除术治疗老年早期肺癌患者的临床疗效及对患者呼吸功能的影响。方法根据术前心肺功能评估后和手术方法的不同将95例老年早期肺癌患者分为A组(n=36,接受胸腔镜下肺段切除术治疗)、B组(n=30,接受胸腔镜下肺叶切除术治疗)、C组(n=29,接受胸腔镜下肺楔形切除术治疗)。比较3组患者的手术效果;术前和术后3个月,比较3组患者呼吸功能的下降幅度,包括用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、最大通气量(MVV)。结果3组患者手术时间、淋巴结清扫数目比较,差异均无统计学意义(P﹥0.05);A组、C组患者术中出血量均低于B组患者,A组患者术后引流时间和术后住院时间均短于B组和C组患者,差异有统计学意义(P﹤0.05)。3组患者术后并发症发生率和局部复发率比较,差异均无统计学意义(P﹥0.05)。与术前相比,术后3个月,FVC、FEV1、MVV下降幅度由高到低依次为C组、B组和A组,差异均有统计学意义(P﹤0.05)。结论胸腔镜下肺段切除术、肺楔形切除术可有效降低老年早期肺癌患者的术中出血量,且肺段切除对促进患者术后恢复及呼吸功能改善更有效。Objective To compare and analyze the clinical effects of thoracoscopic pulmonary segmentectomy,lobectomy and wedge resection in the treatment of early lung cancer in elderly patients and their effects on the recovery of respiratory function.Method A total of 95 patients with early lung cancer were included in the retrospective analysis as group A(n=36,treated by thoracoscopic pulmonary segmentectomy),group B(n=30,treated by thoracoscopic pulmonary lobectomy)and group C(n=29,treated by thoracoscopic pulmonary wedge resection)according to the pre-operative evaluation of cardiopulmonary function and surgical procedures.The surgical effects in the three groups were compared.Before and 3 months after operation,the reduction in respiratory function of the three groups were compared,as assessed by forced vital capacity(FVC),forced expiratory volume in one second(FEV1)and maximal ventilatory volume(MVV).Result There was no significant difference in the operative time and the number of dissected lymph nodes in the 3 groups(P>0.05);the intraoperative blood loss in group A and C was significantly lower than that in group B,and the postoperative drainage time and postoperative hospital stay in group A were significantly shorter compared to those in group B and C(P<0.05).There was no statistically significant difference in the incidence of postoperative complications and local recurrence in the 3 groups of patients(P>0.05).Compared with what was recorded before surgery,the FVC,FEV1,and MVV decreased from high to low with greatest reduction seen in group C,B and A sequentially 3 months after surgery(P<0.05).Conclusion Thoracoscopic segmentectomy and pulmonary wedge resection can effectively reduce intraoperative blood loss in elderly patients with early lung cancer,and segmentectomy is more effective in promoting postoperative recovery and improving respiratory function.

关 键 词：肺癌 胸腔镜 肺段切除 肺叶切除 肺楔形切除 

分 类 号：R734.2[医药卫生—肿瘤]