胸腔镜肺楔形切除术、胸腔镜下肺段切除术、胸腔镜肺叶切除术治疗早期肺癌的疗效比较研究  

Comparative Study on the Curative Effect of Thoracoscopic Lung Wedge Resection,Thoracoscopic Segmentectomy and Thoracoscopic Lobectomy in the Treatment of Early Stage Lung Cancer

作　　者：陈国标[1] 周建平[1] 杜巍[1] 叶志彬[1] 卢星照[1] 胡伟成 刘鑫[3] CHEN Guobiao;ZHOU Jianping;DU Wei;YE Zhibin;LU Xingzhao;HU Weicheng;LIU Xin(Cardiothoracic Surgery Department,the People's Hospital of Dongguan City,Dongguan 523000,China;Cardiothoracic Surgery Department,Zengcheng District People's Hospital,Guangzhou 511300,China;Cardiothoracic Surgery Department,the Fifth Affiliated Hospital of Zunyi Medical University,Zhuhai,Zhuhai 519100,China)

机构地区：[1]广东省东莞市人民医院心胸外科,523000 [2]广东省广州市增城区人民医院心胸外科,511300 [3]遵义医学院第五附属(珠海)医院心胸外科,广东省珠海市519100

出　　处：《实用心脑肺血管病杂志》2022年第4期23-28,共6页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：广东省自然科学基金资助项目(2015A030313046);2019年东莞市社会科技发展(一般)项目(201950715001912)。

摘　　要：目的比较胸腔镜肺楔形切除术、胸腔镜下肺段切除术和胸腔镜肺叶切除术治疗早期肺癌的疗效。方法回顾性选取2017-06-01至2019-09-30东莞市人民医院心胸外科收治的早期肺癌患者112例为研究对象。根据手术方法将患者分为A组(胸腔镜肺楔形切除术,38例)、B组(胸腔镜下肺段切除术,36例)、C组(胸腔镜肺叶切除术,38例)。比较三组患者手术情况(包括手术时间、术中出血量、引流量、引流时间、淋巴结清扫个数)及住院天数,术前、术后24 h和术后72 h视觉模拟评分法(VAS)评分,术前、术后3 d、术后1个月和术后3个月肺功能指标〔包括用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))〕和炎症指标(包括白细胞计数和中性粒细胞计数),预后情况和并发症发生情况。结果B组、C组患者引流量大于A组,引流时间、住院时间长于A组(P<0.05);C组患者引流量大于B组,引流时间、住院时间长于B组(P<0.05)。手术方法与时间在VAS评分上存在交互作用(P<0.05);手术方法、时间在VAS评分上主效应显著(P<0.05)。B组、C组患者术后24、72 h VAS评分高于A组(P<0.05);C组患者术后24、72 h VAS评分高于B组(P<0.05)。A组、B组、C组患者术后24、72 h VAS评分分别高于本组术前,术后72 h VAS评分分别低于本组术后24 h(P<0.05)。手术方法与时间在FVC、FEV_(1)、白细胞计数、中性粒细胞计数上存在交互作用(P<0.05);手术方法、时间在FVC、FEV_(1)、白细胞计数、中性粒细胞计数上主效应显著(P<0.05)。B组、C组患者术后1个月、术后3个月FVC、FEV_(1)低于A组,白细胞计数、中性粒细胞计数高于A组(P<0.05);C组患者术后1个月、术后3个月FVC、FEV_(1)低于B组,白细胞计数、中性粒细胞计数高于B组(P<0.05)。A组、B组、C组患者术后3 d FVC、FEV_(1)分别低于本组术前,白细胞计数、中性粒细胞计数分别高于本组术前(P<0.05);A组、B组、C组患者术后1个月、术后3�Objective To investigate the curative effect of thoracoscopic lung wedge resection,thoracoscopic segmentectomy and thoracoscopic lobectomy in the treatment of early stage lung cancer.Methods A total of 112 patients with early stage lung cancer who were admitted to the Cardiothoracic Surgery Department of the People's Hospital of Dongguan City from 2017-06-01 to 2019-09-30 were retrospectively selected as the research objects.According to the surgical method,the patients were divided into group A(thoracoscopic wedge resection,38 cases),group B(thoracoscopic segmentectomy,36 cases),and group C(thoracoscopic lobectomy,38 cases).The surgical condition(including operation time,intraoperative blood loss,drainage volume,drainage time,number of lymph node dissections)and hospitalization time,Visual Analogue Scoring(VAS)score before operation,24 hours after operation and 72 hours after operation,pulmonary function indexes[including forced vital capacity(FVC),forced expiratory volume in one second(FEV_(1))]and inflammatory indexes(including white blood cell count and neutrophil count)before operation,1 day after operation,5 days after operation,and 3 months after operation,prognosis and complications among the three groups of patients were compared.Results The drainage volume of patients in group B and group C was greater than that of group A,and the drainage time and hospitalization time were longer than those in group A(P<0.05).The drainage volume of patients in group C was greater than that of group B,and the drainage time and hospitalization time were longer than those in group B(P<0.05).There was an interaction between surgical method and time on VAS score(P<0.05);the main effect of surgical method and time on VAS score was significant(P<0.05).The VAS scores of group B and group C were higher than those of group A at 24 and 72 hours after operation(P<0.05);the VAS scores of patients in group C at 24 and 72 hours after operation were higher than those of group B(P<0.05).The VAS scores of patients in group A,group B,and

关 键 词：肺肿瘤 早期治疗 胸腔镜手术 肺楔形切除术 肺段切除术 肺叶切除术 疗效比较研究 

分 类 号：R734.2[医药卫生—肿瘤]