肺叶切除术与肺楔形切除术治疗Ⅰb期老年非小细胞肺癌患者的疗效比较  

Effect of lobectomy and wedge resection on prognosis of elderly patients with stage Ⅰb NSCLC

作　　者：刘继东[1] 杨燕[1] 刘莹[1] LIU Jidong;YANG Yan;LIU Ying(Department of Respiratory Medicine,Panzhihua Central Hospital,Sichuan Panzhihua 617067,China)

机构地区：[1]攀枝花市中心医院呼吸内科,四川攀枝花617067

出　　处：《现代肿瘤医学》2021年第2期253-257,共5页Journal of Modern Oncology

摘　　要：目的:探讨肺叶切除、肺楔形切除两种手术方式治疗Ⅰb期老年非小细胞肺癌(NSCLC)患者的疗效。方法:收集130例NSCLC患者为研究对象,根据手术方式的不同,将患者分为肺叶切除组与肺楔形切除组,比较两组患者的预后差异。结果:与肺楔形切除组相比,肺叶切除组患者的手术时间、胸管引流时间明显更长,失血量更多,差异具有统计学意义(P<0.05),但两组患者的术后并发症发生率、并发症类型、住院时间无明显差异(P>0.05)。肺叶切除组、肺楔形切除组的总体生存率分别为76.9%(70/91)、82.1%(32/39),复发率分别为32.9%(30/91)、38.5%(15/39),差异均无统计学意义(P>0.05)。病理分级、病理类型、T分期、胸膜侵犯是影响患者5年生存率的独立性危险因素(P<0.05),非腺癌类型、存在胸膜侵犯、病理分级越低、T分期越高,患者的5年生存率就越低。病理分级、病理类型、T分期是影响患者复发率的独立性危险因素(P<0.05),非腺癌类型、病理分级越低、T分期越高,患者的复发率越高。结论:对Ⅰb期老年NSCLC患者,肺楔形切除可在保留更多肺组织的基础上取得与肺叶切除相似的远期生存率及复发控制率,值得临床推广。Objective:To investigate the effect of lobectomy and wedge resection on the prognosis of elderly patients with stage Ⅰb NSCLC.Methods:A total of 130 patients with NSCLC were selected and divided into lobectomy group and wedge resection group.The difference between the two groups was compared.Results:Compared with the cuneate resection group,the operation time,the drainage time of the thoracic duct were significantly longer and the blood loss was more(P<0.05),but there was no significant difference in the incidence of complications,type of complications and the time of hospitalization in the two groups(P>0.05).The total survival rate of the lobectomy group and the lung wedge resection group was 76.9% and 82.1% respectively,and the recurrence rates were 32.9% and 38.5% respectively,and the difference was not statistically significant(P>0.05).Pathological classification,pathological type,T staging and pleural invasion were independent risk factors(P<0.05).The type of non adenocarcinoma,pleural invasion,the lower the pathological grade,the higher the T staging were corrected with the lower the 5 years survival rate of the patients.Pathological grade,pathological type and T staging were independent risk factors that affect the 5 years survival rate of the patients(P<0.05).The lower the type of adenocarcinoma,the lower the pathological grade,the higher the T staging,the higher the recurrence rate of the patients.Conclusion:For the elderly NSCLC patients with stage Ⅰ_b,the cuneate resection of lung can obtain the similar long-term survival rate and relapse control rate on the basis of retaining more lung tissues and lobectomy,which is worthy of clinical promotion.

关 键 词：非小细胞肺癌 肺叶切除 肺楔形切除 总体生存率 

分 类 号：R734.2[医药卫生—肿瘤]