达芬奇机器人与胸腔镜手术治疗对肺癌根治术患者近期疗效、术后营养水平和免疫功能的影响比较  

Comparison of the effects of Da Vinci robotic surgery and thoracoscopic surgery on the short-term curative effect,postoperative nutritional status and immune function of patients undergoing radical resection of lung cancer

作　　者：周静 夏红香[1] 茅昌敏[1] 朱文静 王颖 丁敏[1] ZHOU Jing;XIA Hong-xiang;MAO Chang-min(Department of Thoracic Surgery,Jiangsu Cancer Hospital,Nanjing Jiangsu 210009,China.)

机构地区：[1]江苏省肿瘤医院胸外科,江苏南京210009 [2]江苏省肿瘤医院手术室,江苏南京210009

出　　处：《临床和实验医学杂志》2022年第3期303-307,共5页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金-青年项目(编号:81802907)。

摘　　要：目的对比分析达芬奇机器人手术和胸腔镜手术对肺癌根治术患者近期疗效、术后营养状况和免疫功能的影响。方法回顾性选取2019年12月至2020年11月在江苏省肿瘤医院接受肺癌根治术治疗的患者120例,根据患者所用手术方式的不同分为胸腔镜组和达芬奇组,各60例。胸腔镜组患者接受胸腔镜手术治疗,达芬奇组接受达芬奇机器人辅助手术治疗。比较两组患者手术时间、术中出血量、术后引流管留置时间、术后住院时间以及术后并发症等一般情况。术后3 d,采用人酶联免疫吸附试验(ELISA)法检测患者血清丙二醛、谷胱甘肽过氧化物酶(GSH-Px)、总抗氧化能力(T-AOC)、总超氧化物歧化酶(T-SOD)水平;采用免疫比浊法检测血清前白蛋白水平;采用相应试剂盒检测血清中白蛋白含量;采用自动血液分析仪检测血清血红蛋白含量;CytoFLEX流式细胞仪分析患者外周血T淋巴细胞亚型。结果达芬奇组患者手术时间为(192.32±53.21)min,显著高于胸腔镜组[(156.32±43.25)min],但达芬奇组患者术中失血量、引流管留置时间和住院时间为(175.32±80.12)mL、(3.38±5.44)d、(7.12±1.03)d,均显著低于胸腔镜组[(202.32±79.61)mL、(5.67±2.32)d、(8.91±1.52)d],差异均有统计学意义(P<0.05)。胸腔镜组和达芬奇组患者术后并发症总发生率比较差异无统计学意义(P>0.05)。达芬奇组患者术后血清丙二醛水平为(8.36±0.89)nmol/L,显著低于胸腔镜组[(12.85±1.62)nmol/L],而血清GSH-px、T-AOC、T-SOD、前白蛋白、白蛋白和血红蛋白水平为(215.32±32.95)U/L、(12.58±2.32)U/mL、(93.56±7.99)U/mL、(221.38±42.35)g/L、(28.96±4.69)g/L、(84.35±7.72)g/L,均显著高于胸腔镜组[(156.32±11.25)U/L、(8.36±1.05)U/mL、(74.62±8.32)U/mL、(191.32±28.33)g/L、(26.32±4.28)g/L、(76.25±8.02)g/L],差异均有统计学意义(P<0.05)。达芬奇组患者术后营养风险发生率为58.33%,显著低于胸腔镜组(76.67%),差异有统计Objective Comparative analysis of the effects of Da Vinci robotic surgery and thoracoscopic surgery on the short-term curative effect,postoperative nutritional status and immune function of patients undergoing radical resection of lung cancer.Methods A total of 120 patients who received radical mastectomy for lung cancer in Jiangsu Cancer Hospital from December 2019 to November 2020 were retrospectively selected.Patients were divided into thoracoscopy group and Da Vinci group according to different surgical methods,each group 60 cases.Patients in the thoracoscopy group received thoracoscopic surgery for treatment,the Da Vinci group received Da Vinci robot-assisted surgery.The operation time,intraoperative blood loss,postoperative drainage tube indwelling time,postoperative hospital stay time,and postoperative complications were compared between the two groups of patients.Three days after operation,human enzyme-linked immunosorbent assay kit(ELISA)was used to detect serum malondialdehyde(MDA),glutathione peroxidase(GSH-Px)and total antioxidant capacity(T-AOC)and total superoxide dismutase(T-SOD)levels in patients;the level of prealbumin in serum of patients was detected by immunoturbidimetric method;serum albumin content was detected using corresponding kits;serum hemoglobin content was detected by automatic blood analyzer;peripheral blood T lymphocyte subtypes were detected by Analysis CytoFLEX flow cytometer.Results The operation time of the Da Vinci group was(192.32±53.21)min,which was significantly higher than that of the thoracoscopy group[(156.32±43.25)min],but the intraoperative blood loss,drainage tube indwelling time and hospital stay of the Da Vinci group were(175.32±80.12)mL,(3.38±5.44)d,(7.12±1.03)d,which were significantly lower than those of the thoracoscopy group[(202.32±79.61)mL,(5.67±2.32)d,(8.91±1.52)d],the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of postoperative complications between the thoracoscopy group and the Da V

关 键 词：肺癌 达芬奇机器人手术 胸腔镜 营养 免疫功能 

分 类 号：R734.2[医药卫生—肿瘤]