胸腔镜下亚肺叶切除术联合纵隔淋巴结采样治疗老年早期非小细胞肺癌的临床效果  

Clinical Efficacy of Thoracoscopic Sublobectomy Combined with Mediastinal Lymph Node Sampling in Treatment of Early Patients with Non-small Cell Lung Cancer

作　　者：蔡宝松 张雁 赵晨阳 张彦匣 李海英 赵占伟 CAI Bao-song;ZHANG Yan;ZHAO Chen-yang;ZHANG Yan-xia;LI Hai-ying;ZHAO Zhan-wei(Department of Cardiothoracic Surgery,the First Hospital of Zhangjiakou City,Zhangjiakou,Hebei 075000,China;Department of Anesthesiology,the 81 Military Hospital of PLA,Zhangjiakou,Hebei 0750002,China;Department of Surgery,People's Hospital of Raoyang City,Raoyang,Hebei 053900,China)

机构地区：[1]张家口市第一医院心胸外科,河北张家口075000 [2]解放军陆军第八十一集团军医院麻醉科,河北张家口075000 [3]饶阳县人民医院外科,河北饶阳053900

出　　处：《解放军医药杂志》2022年第2期32-35,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省中医药管理局科研基金项目(2019351);张家口科学技术研究与发展计划项目(1921083D)。

摘　　要：目的探讨胸腔镜下亚肺叶切除术联合纵隔淋巴结采样治疗老年早期非小细胞肺癌(NSCLC)的临床效果。方法选取2017年1月—2020年1月收治的老年早期NSCLC 138例,行传统开胸肺叶切除术69例作为对照组,行胸腔镜下亚肺叶切除术联合纵隔淋巴结采样69例作为观察组。比较2组围术期指标、肺功能评分及术后并发症发生情况,并分析2组术后1年生存情况。结果观察组手术时间、术后引流天数及住院时间短于对照组,术中出血量、淋巴结清扫个数、纵隔淋巴结清扫个数、术后引流量少于对照组,术后疼痛评分低于对照组(P<0.05)。2组术后用力肺活量(FVC)、最大通气量(MVV)均低于术前,但观察组术后FVC、MVV高于对照组(P<0.05)。观察组术后并发症发生率低于对照组,术后1年生存率高于对照组(P<0.05)。结论胸腔镜下亚肺叶切除术联合纵隔淋巴结采样治疗老年早期NSCLC效果确切,并发症发生率低,可改善患者生存情况。Objective To analyze clinical efficacy of thoracoscopic sublobectomy combined with mediastinal lymph node sampling in treatment of early patients with non-small cell lung cancer(NSCLC).Methods A total of 138 elderly patients with NSCLC admitted between January 20017 and January 2020 were selected.Among them,69 patients undergoing traditional lobectomy were enrolled as control group,while other 69 patients undergoing thoracoscopic sublobectomy combined with mediastinal lymph node sampling were enrolled as observation group.The perioperative indicators,lung function scores and incidence rate of postoperative complications were compared,and the 1-year survival rates were also analyzed in two groups.Results Compared with those in control group,operative duration,days of postoperative drainage and length of stay were shorter,and volume of intraoperative bleeding,number of lymph nodes dissection,number of mediastinal lymph nodes dissection and volume of postoperative drainage were less,and the score of postoperative pain was lower in the observation group(P<0.05).Values of postoperative forced vital capacity(FVC)and maximum ventilation volume(MVV)were lower than those before operation in two groups,but the values in observation group were higher than those in control group(P<0.05).Compared with those in control group,incidence rate of postoperative complications was lower,while the 1-year survival rate was higher in observation group(P<0.05).Conclusion Thoracoscopic sublobectomy combined with mediastinal lymph node sampling is effective in treatment of early patients with NSCLC,and it may achieve low incidence rate of complications and improve survival conditions of patients.

关 键 词：癌 非小细胞肺 亚肺叶切除术 胸腔镜检查 纵隔淋巴结采样 肺活量 最大通气量 手术后并发症 

分 类 号：R734.2[医药卫生—肿瘤]