胸腔镜微创手术与传统开胸手术治疗非小细胞肺癌患者的临床疗效比较  

Comparison of clinical efficacy of thoracoscopic minimally invasive surgery andconventional thoracotomy in non-small cell lung cancer

作　　者：郑慧禹[1] 邵志鹏 赵冬峰[1] 杨玉伦[1] ZHENG Huiyu;SHAO Zhipeng;ZHAO Dongfeng;YANG Yulun(Department of Thoracic Surgery,People’s Hospital of Zhengzhou,Zhengzhou 450003,He’nan,China)

机构地区：[1]郑州人民医院胸外科,郑州4500030

出　　处：《癌症进展》2021年第5期499-502,506,共5页Oncology Progress

摘　　要：目的对比分析胸腔镜微创手术与传统开胸手术治疗非小细胞肺癌(NSCLC)患者的临床疗效。方法根据手术方式的不同将120例NSCLC患者分为胸腔镜组(n=60,接受胸腔镜微创手术)和开胸组(n=60,接受传统开胸手术)。比较两组患者的手术情况、临床疗效、术后24 h的视觉模拟评分法(VAS)评分、术前和术后3天的血清指标[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)、C反应蛋白(CRP)]及并发症发生情况。采用欧洲癌症研究与治疗组织肺癌患者生存质量量表(EORTC QLQ-LC43)评价术前和术后1年两组患者的生活质量。结果胸腔镜组患者的手术时间、引流管置管时间、住院时间均明显短于开胸组,术中出血量明显少于开胸组,差异均有统计学意义(P﹤0.01)。胸腔镜组和开胸组患者的客观缓解率(ORR)和疾病控制率(DCR)比较,差异均无统计学意义(P﹥0.05);胸腔镜组患者术后24 h的VAS评分明显低于开胸组,差异有统计学意义(P﹤0.01)。术后3天,胸腔镜组患者的血清IL-6、TNF-α、IL-10、CRP水平均低于开胸组,差异均有统计学意义(P﹤0.05)。术后1年,胸腔镜组患者的情绪、日常生活、活动能力、社会/家庭生活、肺癌附加因素评分及总分均高于开胸组,差异均有统计学意义(P﹤0.05)。胸腔镜组患者的并发症总发生率明显低于开胸组,差异有统计学意义(P﹤0.01)。结论胸腔镜微创手术与传统开胸手术治疗NSCLC均具有较好的近期临床效果,但前者在手术创伤、术后恢复、住院时间、术后并发症等方面更具优势,且患者生活质量更佳。Objective To compare the clinical efficacy of thoracoscopic minimally invasive surgery and conventional thoracotomy in non-small cell lung cancer(NSCLC).Method 120 patients with NSCLC were selected and divided into thoracoscopic group(n=60,treated with thoracoscopic minimally invasive surgery)and thoracotomy group(n=60,treated with conventional thoracotomy).The operation condition,clinical efficacy,scores of visual analogue scale(VAS)at 24 hours after surgery,the serum levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),interleukin-10(IL-10)and C-reactive protein(CRP)before and 3 days after surgery,and complications were compared between the two groups.European Organization for Research and Treatment of Cancer quality of life-lung cancer 43(EORTC QLQ-LC43)was used to evaluate the quality of life before and 1 year after surgery.Result The operation time,drainage tube indwelling time,hospital stay,and intraoperative blood loss in the thoracoscopic group were shorter or lower than those in the thoracotomy group(P<0.01).There was no significant difference in objective response rate(ORR)and disease control rate(DCR)between the two groups(P>0.05);the score of VAS at 24 hours after surgery in the thoracoscopic group was lower than that in the thoracotomy group(P<0.01).The serum levels of IL-6,TNF-α,IL-10 and CRP at 3 days after surgery in the thoracoscopic group were lower than those in the thoracotomy group(P<0.05).The scores of mood,daily life,activity,social/family life,additional factors of lung cancer and total scores in the thoracoscopic group were significantly higher than those in the thoracotomy group(P<0.05).The incidence of complications in the thoracoscopic group was lower than that in the thoracotomy group(P<0.01).Conclusion Thoracoscopic minimally invasive surgery and conventional thoracotomy have good short-term clinical efficacy in the treatment of NSCLC patients,but the former has more advantages in surgical trauma,postoperative recovery,length of hospital stay,postoperative complications,wi

关 键 词：非小细胞肺癌 胸腔镜微创手术 传统开胸手术 临床疗效 生活质量 

分 类 号：R734.2[医药卫生—肿瘤]