全胸腔镜解剖性肺段切除术治疗肺部小结节对患者手术指标肺功能及引流量的影响  

Effect of Total Thoracoscopic Anatomic Segmentectomy for Small Pulmonary Nodules on Surgical Parameters Pulmonary Function and Drainage Volume

作　　者：徐士杰 洪卫东[1] 江海峰 卢金山[1] 陈建 胡蔚 XU Shijie;HONG Weidong;JIANG Haifeng(The First People's Hospital of Chuzhou City,Anhui Chuzhou 23900,China)

机构地区：[1]安徽省滁州市第一人民医院南区心胸外科,安徽滁州239000

出　　处：《河北医学》2021年第2期242-246,共5页Hebei Medicine

基　　金：安徽省自然科学基金项目,(编号:1808063MH126)。

摘　　要：目的:探究全胸腔镜解剖性肺段切除术对肺部小结节患者手术指标、肺功能及引流量的影响。方法:前瞻性选取2016年2月至2020年4月于本院诊治的肺部小结节患者84例,根据随机数字表法简单随机分为两组,其中对照组(42例)进行了全胸腔镜肺叶切除术,研究组(42例)进行了全胸腔镜肺段切除术。比较两组手术指标、肺功能指标(FEV1、FVC、FEV1/FVC)以及术后并发症之间的差异。结果:两组术中淋巴结清扫数量无显著差异(P>0.05),但研究组术中出血量、引流量、引流时间及住院时间均少于对照组,差异具有统计学意义(P<0.05)。重复测量方差分析显示,治疗前,两组FEV1%、FVC%、MMV%比较无显著差异(P<0.05),治疗3、6、12个月后,研究组FEV1%、FVC%、MMV%均明显高于对照组(P<0.05)。另并发症结果显示,研究组患者术后并发症总发生率为4.76%,对照组为9.52%,组间比较差异无统计学意义(χ^2=0.718,P>0.05)。结论:全胸腔镜解剖性肺段切除术治疗治疗肺部小结节患者的整体疗效优于肺叶切除术,其可较大程度保留患者正常肺组织,且对患者肺功能影响较小。Objective:To investigate the effects of total thoracoscopic anatomic pulmonary segmentectomy on surgical parameters,lung function and drainage volume of pulmonary nodules.Methods:84 patients with small pulmonary nodules in our hospital from February 2016 to April 2020 were prospectively selected and randomly divided into two groups according to the random number table method.Among them,the control group(42 cases)underwent total thoracoscopic lobectomy,and the study group(42 cases)underwent thoracoscopic segmentectomy.Differences in surgical indicators,lung function indicators(FEV1,FVC,FEV1/FVC)and postoperative complications were compared between the two groups.Results:There was no significant difference in intraoperative lymph node dissection between the two groups(P>0.05),but the intraoperative blood loss,drainage volume,drainage time and hospital stay in the study group were all lower than those in the control group,and the difference was statistically significant(P<0.05).Analysis of variance of repeated measures showed that before treatment,there was no significant difference in FEV1%,FVC%and MMV%between the two groups(P<0.05).After 3,6 and 12 months of treatment,FEV1%,FVC%and MMV%in the study group were significantly higher than those in the control group(P<0.05).In addition,the total incidence of postoperative complications was 4.76%in the study group and 9.52%in the control group,with no statistically significant difference between the groups(χ^2=0.718,P>0.05).Conclusion:The overall efficacy of total thoracoscopic anatomic pulmonary segmentectomy in the treatment of pulmonary nodules is better than that of lobectomy,which can largely retain the normal lung tissue of the patients and has less impact on the pulmonary function of the patients.

关 键 词：肺部小结节 全胸腔镜 肺段切除术 肺叶切除术 肺功能 

分 类 号：R655.3[医药卫生—外科学]