胸腔镜下肺叶与肺段切除术治疗早期非小细胞肺癌的临床效果观察  

Clinical effect observation of thoracoscopic lobectomy and segmentectomy in the treatment of early non-small cell lung cancer

作　　者：张炳太 张雷[1] 刘军[2] 李洪林[2] 刘学刚[1] ZHANG Bing-tai;ZHANG Lei;LIU Jun;LI Hong-lin;LIU Xue-gang(Department of Thoracic and Cardiac Surgery,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233004,China;不详)

机构地区：[1]蚌埠医学院第一附属医院胸心外科,安徽蚌埠233004 [2]蚌埠市第三人民医院胸心外科,安徽蚌埠233000

出　　处：《中华全科医学》2022年第3期399-402,共4页Chinese Journal of General Practice

基　　金：安徽省教育厅重点课题(KJ2019A0340)。

摘　　要：目的观察胸腔镜下肺叶与肺段切除术治疗早期非小细胞肺癌(NSCLC)患者的临床疗效,并分析2组差异。方法选取2018年1月—2019年12月于蚌埠医学院第一附属医院胸心外科就诊的早期NSCLC患者60例,根据手术方式分为2组,观察组采用胸腔镜下肺段切除术(30例),对照组采用胸腔镜下肺叶切除术(30例)。对比2组围手术期相关指标及术后并发症发生情况,分析2组术前、术后肺功能和生存质量差异。结果观察组与对照组相比,手术时间长[(140.32±12.31)min vs.(109.82±14.52)min],术后引流时间和住院时间短[(5.12±1.07)d vs.(5.89±0.95)d,(7.89±1.24)d vs.(9.18±1.32)d],术中出血量少[(65.09±15.45)mL vs.(86.46±17.87)mL,均P<0.05]。观察组术后肺漏气发生率较高,术后2组并发症总发生率差异无统计学意义(P>0.05)。2组术前肺功能指标(FEV_(1)、FVC)差异无统计学意义(均P>0.05);术后2组组间及组内不同时点间肺功能指标差异有统计学意义(均P<0.05);组别与时间存在交互作用(F_(交互)=65.982、61.374,均P<0.05)。2组术前KPS评分差异无统计学意义(P>0.05);术后2组组间及组内不同时点间KPS评分差异有统计学意义(均P<0.05);组别与时间存在交互作用(F_(交互)=50.233,P<0.05)。结论胸腔镜肺段切除术治疗早期NSCLC患者总体效果优于肺叶切除术,术中出血少,术后恢复快,对肺功能影响小,具有重要的临床应用价值。Objective To observe the clinical efficacy of thoracoscopic lobectomy and segmental lung resection in the treatment of patients with early stage non-small cell lung cancer(NSCLC),and analyse the differences between the two groups.Methods Sixty patients with early NSCLC who were admitted to the Department of Cardiac Surgery of the First Affiliated Hospital of Bengbu Medical College from January 2018 to December 2019 were selected.According to surgical methods,they were divided into the observation group(thoracoscopic segmentectomy)(n=30)and control group(thoracoscopic lobectomy)(n=30).Perioperative related indicators and postoperative complications were compared between the two groups,and preoperative and postoperative lung function and quality of life were analysed.Results Compared with the control group,the observation group had longer operation time[(140.32±12.31)min vs.(109.82±14.52)min],shorter postoperative drainage time and hospitalisation time[(5.12±1.07)days vs.(5.89±0.95)days,(7.89±1.24)days vs.(9.18±1.32)days],and lesser intraoperative blood loss[(65.09±15.45)mL vs.(86.46±17.87)mL,all P<0.05].The incidence of pulmonary air leakage was higher in the observation group,and no statistical significance was observed in the incidence of postoperative complications between the two groups(P>0.05).No significant difference was observed in preoperative lung function indexes(FEV_(1),FVC)between the two groups(all P>0.05).Statistically significant differences were observed in lung function indexes between the two groups and within the two groups at different time points after operation(all P<0.05).An interaction was observed between group and time(F_(interaction)=65.982,61.374,all P<0.05).No significant difference was observed in preoperative KPS scores between the two groups(P>0.05).Statistically significant differences were observed in the KPS scores between the two groups and at different time points within the group after surgery(all P<0.05).An interaction was observed between group and time(F_(interacti

关 键 词：完全胸腔镜 肺叶切除术 肺段切除术 早期非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤] R730.56[医药卫生—临床医学]