同期双侧胸腔镜手术在肺癌外科治疗中的应用价值  

The application value of simultaneous bilateral thoracoscopic surgery in the surgical treatment of lung cancer

作　　者：迟英民 杨景珑 矫财宇 CHI Yingmin;YANG Jinglong;JIAO Caiyu(Department of Thoracic Surgery,Wafangdian Central Hospital,Dalian,Liaoning,116300,China)

机构地区：[1]瓦房店市中心医院胸外科,辽宁大连116300

出　　处：《当代医学》2021年第7期50-53,共4页Contemporary Medicine

摘　　要：目的分析肺癌外科治疗中同期双侧胸腔镜手术的临床应用价值。方法选取本院2016年1月至2018年12月收治的80例DPLC患者为研究对象,根据患者治疗方式不同分为同期双侧胸腔镜手术组(n=22)和分期胸腔镜手术组(n=58)。同期组患者行双侧肿瘤切除+淋巴清扫同期手术治疗,分期组患者行分期肿瘤切除+淋巴清扫手术治疗。比较两组患者的手术时间、术中出血量、术后胸腔引流管留置时间、住院时间;于两组患者手术治疗前后,检测创伤后应激刺激因子[白细胞介素-6(IL-6)、α1-抗胰蛋白酶(α1-AT)],并比较两组患者术后并发症发生率。结果同期双侧胸腔镜手术组手术时间、术后胸腔引流管留置时间及住院时间均短于分期胸腔镜手术组,术中出血量少于分期胸腔镜手术组(P<0.05)。术前,两组血清IL-6、α1-AT水平比较差异均无统计学意义;术后第1天、第3天,同期双侧胸腔镜手术组血清IL-6、α1-AT水平均低于分期胸腔镜手术组(P<0.05)。同期双侧胸腔镜手术组术后并发症发生率为9.90%,低于分期胸腔镜手术组的18.97%,差异有统计学意义(P<0.05)。结论予以DPLC患者同期双侧胸腔镜手术治疗能有效减少手术创伤,降低术后创伤应激刺激及手术并发症发生率,进而增强手术效果。Objective To analyze the clinical application value of simultaneous bilateral thoracoscopic surgery in lung cancer surgery.Methods 80 cases of DPLC patients in our hospital from January 2016 to December 2018 were selected as the research subjects,they were divided into bilateral thoracoscopic surgery group(n=22)and staged thoracoscopic surgery group(n=58)according to the different treatment methods.The patients in the same period group were treated with bilateral tumor resection and lymph node dissection at the same time,and the patients in the staging group were treated with staged tumor resection and lymph node dissection.The operation time,intraoperative blood loss,postoperative thoracic drainage tube indwelling time and hospitalization time between the two groups were compared;before and after the operation,the post-traumatic stress stimulus factors[interleukin-6(IL-6),α1-antitrypsin(α1-AT)]were detected,and the incidence of postoperative complications was compared.Results The operation time,postoperative drainage tube indwelling time and hospitalization time in the bilateral thoracoscopic surgery group were shorter than those in the staged thoracoscopic surgery group,and the intraoperative blood loss was less than that in the staged VATS group(P<0.05).During the same period,the total incidence of postoperative complications in bilateral thoracoscopic surgery group was 9.90%,which was lower than 18.97%of staged thoracoscopic surgery group,and the difference was statistically significant(P<0.05).Conclusion The simultaneous bilateral thoracoscopic surgery for DPLC patients can effectively reduce the surgical trauma,reduce the incidence of postoperative stress stimulation and surgical complications,and then improve the surgical effect.

关 键 词：肺癌 同期双侧胸腔镜手术 分期胸腔镜术 创伤应激刺激 

分 类 号：R734.2[医药卫生—肿瘤]