单孔与三孔胸腔镜术对老年非小细胞肺癌患者的术后影响  

Effects of Single-port and Three-port Thoracoscopic Surgery on Older Patients with Non-small Cell Lung Cancer

作　　者：冯喆[1] 高继东[1] 郑明非[1] 殷传军[1] 冯立峰 姚锐[2] 陈明国[3] Feng Zhe;Gao Jidong;Zheng Mingfei;Yin Chuanjun;Feng Lifeng;Yao Rui;Chen Mingguo(Department of Thoracic Surgery,the sixth Hospital of Beijing,Beijing 100007;Department of Pharmacy,Beijing Geriatric Hospital,Beijing 100007;Department of Surgery,Southern District of Guanganmen Hospital,Chinese Academy of Traditional Chinese Medicine,Beijing 100038)

机构地区：[1]北京市第六医院胸外科,北京100007 [2]北京老年医院药学部,北京100007 [3]中国中医科学院广安门医院南区外科,北京100038

出　　处：《国际老年医学杂志》2021年第6期354-359,共6页International Journal of Geriatrics

基　　金：首都临床特色应用研究专项基金(Z161100001013189)。

摘　　要：目的对比单孔与三孔胸腔镜术对老年非小细胞肺癌患者术后心肺功能及血液mir-576-3p、三叶因子3(TFF3)、白细胞介素32(IL-32)指标的影响。方法选取2017年2月~2019年8月北京市第六医院收治的老年非小细胞肺癌患者124例,分为研究组与对照组,各62例。研究组给予单孔胸腔镜手术治疗,对照组给予三孔胸腔镜手术治疗,记录患者术后心肺功能与血清mir-576-3p、TFF3、IL-32变化情况。结果两组手术时间、清扫淋巴结总数比较差异无统计学意义(P>0.05);研究组术中出血量、术后胸管留置时间与术后住院时间均显著少于对照组(P<0.05);研究组术后14 d的肺炎、肺漏气、心力衰竭、呼吸衰竭等并发症发生率显著低于对照组(P<0.05);研究组术后1 d与14 d的血清TFF3值显著高于对照组(P<0.05),血清IL-32值显著低于对照组(P<0.05)。研究组术后1 d、14 d的全血mir-576-3p相对表达水平均显著低于对照组(P<0.05)。研究组术后1 d的心率(HR)、术后14 d的HR、第1秒用力呼气容积(FEV1)、最大通气量(MVV)、一氧化碳弥散量(DLco)指标均显著低于对照组(P<0.05)。结论相对于三孔腹腔镜手术,单孔腹腔镜手术治疗老年非小细胞肺癌能减少心肺功能障碍的发生,抑制mir-576-3p与IL-32的表达,促进TFF3的表达,有利于患者康复。Objective To explore the effects of single-port and three-port thoracoscopic surgery on cardiopulmonary function,the levels of serum mir-576-3 p,trefoil factor 3(TFF3)and interleukin-32(IL-32)in older patients with non-small cell lung cancer after surgery.Methods 124 older patients with non-small cell lung cancer in the sixth Hospital of Beijing were enrolled from February 2017 to August 2019.The patients were divided into the study group(62 cases)and control group(62 cases).The study group was treated with single-port thoracoscopic surgery,and the control group were treated with three-port thoracoscopic surgery.The cardiopulmonary function and the levels of serum mir-576-3 p,TFF3 and IL-32 were recorded.Results There were no significant differences in the operation duration,the total number of lymph nodes removed between the two groups(P>0.05).The intraoperative blood loss,postoperative chest tube indwelling time and postoperative hospital stay in the study group were significantly less than those in the control group(P<0.05).The incidences of pneumonia,lung leak,heart failure and respiratory failure were significantly lower in the study group than those in the control group(P<0.05)at 14 d after surgery.The level of serum TFF3 was higher(P<0.05),and the level of IL-32 was lower(P<0.05)in the study group than that in the control group at 1 d and 14 d after surgery.The relative expression level of mir-576-3 p in blood in the study group was significantly lower than that in the control group at 1 d and 14 d after surgery(P<0.05).The HR at 1 d,HR,FEV1,MVV,DLCOat 14 d in the study group were significantly lower than those in the control group(P<0.05).Conclusion Compared with three-port laparoscopic surgery,single-port thoracoscopic surgery may reduce the occurrence of cardiopulmonary dysfunction,inhibit the expression of serum mir-576-3 p and IL-32,and promote the expression of TFF3 in the treatment of older patients with non-small cell lung cancer.These are helpful to the patient’s recovery.

关 键 词：单孔胸腔镜 非小细胞肺癌 心肺功能 mir-576-3p 三叶因子3 白细胞介素32 

分 类 号：R734.2[医药卫生—肿瘤]