不同胸腔镜手术治疗非小细胞肺癌对术后血清炎症因子和氧化应激水平及肺功能的影响  

Effects of different thoracoscopic surgery for non-small cell lung cancer on postoperative serum inflammatory factors,oxidative stress levels and lung function

作　　者：李奎 范国华[2] 王志维[3] LI Kui;FAN Guohua;WANG Zhiwei(Department of Thoracic and Cardiovascular Surgery,Yilin Hospital of Yichang,Yichang,Hubei,443100,China;Department of Thoracic Surgery,Renmin Hospital ofWuhan University,Wuhan,Hubei,430060,China;Department of Cardiovascular Surgery,Renmin Hospital ofWuhan University,Wuhan,Hubei,430060,China)

机构地区：[1]宜昌市夷陵医院胸心血管外科,湖北宜昌443100 [2]武汉大学人民医院胸外科,湖北武汉430060 [3]武汉大学人民医院心血管外科,湖北武汉430060

出　　处：《当代医学》2022年第10期12-15,共4页Contemporary Medicine

摘　　要：目的探究单操作孔胸腔镜手术(single portvideo-assistedthoracoscopicsurgery,SP-VATS)及胸腔镜辅助小切口(video-assisted mini-thoracotomy,VAMT)手术对非小细胞肺癌的疗效及术后炎症因子、氧化应激指标和肺功能的影响。方法回顾性分析2019年1月至2020年11月于本院接受胸腔镜手术治疗的71例非小细胞肺癌患者的临床资料,其中40例行SP-VATS术(SP-VATS组),31例行VAMT术(VAMT组),比较两组术中及术后相关指标(术中出血量、手术时间、术后引流时间、术后总引流量、下床活动时间)与手术前后血清炎症指标[白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和C反应蛋白(CRP)]、血清氧化应激指标(P物质和皮质醇)及肺功能[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)和每分钟最大通气量(MVV)]变化情况。结果SP-VATS组术中出血量、术后总引流量均小于VAMT组,术后引流时间、下床活动时间均短于VAMT组(P<0.05)。术后1个月,SP-VATS组FVC、FEV1及MVV均高于VAMT组,差异有统计学意义(P<0.05)。术后7 d,SP-VATS组血清P物质、皮质醇、IL-6、TNF-α及CRP水平均低于VAMT组,差异有统计学意义(P<0.05)。SP-VATS组并发症发生率为7.50%,VAMT组并发症发生率为6.45%,两组并发症发生率比较差异无统计学意义。结论SP-VATS能有效改善围手术期指标,对患者术后肺功能影响较小,且能降低患者术后机体炎症反应和应激反应,利于患者术后恢复。Objective To explore the efficacy of single port video-assisted thoracoscopic surgery(SP-VATS)and video-assisted mini-thoracotomy(VAMT)on inflammatory factors,oxidative stress and lung function in patients with non-small cell lung cancer.Methods The clinical data of 71 patients with non-small cell lung cancer who underwent thoracoscopic surgery in our hospital from January 2019 to November 2020 were retrospec-tive analyzed.Among them,40 cases underwent SP-VATS(SP-VATS group)and 31 cases underwent VAMT operation(VAMT group),the intraopera-tive and postoperative related indexes(intraoperative blood loss,operation time,postoperative drainage time,postoperative total drainage volume,and ambulation time)and the serum inflammatory indexes(interleukin-6[IL-6],tumor necrosis factor-α[TNF-α]and C-reactive protein[CRP]),se-rum oxidative stress indexes(P substance and cortisol)and lung function(forced vital capacity[FVC],forced expiratory volume in the first second[FEV1]and maximum ventilation per minute[MVV])changes were compared between the two groups.Results The intraoperative blood loss and postoperative total drainage volume in the SP-VATS group were less than those in the VAMT group,and the postoperative drainage time and time to get out of bed were shorter than those in the VAMT group(P<0.05).1 month after operation,FVC,FEV1 and MVV in SP-VATS group were higher than those in VAMT group,and the difference was statistically significant(P<0.05).At 7 days postoperatively,serum P substance,cortisol,IL-6,TNF-αand CRP in the SP-VATS group were lower than those in the VAMT group,and the difference was statistically significant(P<0.05).The com-plication rate of SP-VATS group was 7.50%,and that of VAMT group was 6.45%,there was no significant difference in the complication rate be-tween the two groups.Conclusion SP-VATS can effectively improve the perioperative index,has little effect on the postoperative lung function of the patient,and can reduce the postoperative inflammatory response and stress response of the patient's

关 键 词：非小细胞肺癌 单操作孔胸腔镜手术 胸腔镜辅助小切口 炎症因子 氧化应激 

分 类 号：R734.2[医药卫生—肿瘤]