Ⅰ、Ⅱ期非小细胞肺癌患者采用完全胸腔镜单向式肺叶切除术的围术期疗效分析  

Perioperative efficacy of complete thoracoscopic unilateral lobectomy in patients with stageⅠ,Ⅱnon-small cell lung cancer

作　　者：王志华 李叙 WANG Zhihua;LI Xu(Department of Cardio-Thoracic Surgery,904 Hospital of Joint Logistics Support Force of PLA,Jiangsu Wuxi 214000,China)

机构地区：[1]解放军联勤保障部队第904医院心胸外科,江苏无锡214000

出　　处：《现代肿瘤医学》2022年第21期3915-3918,共4页Journal of Modern Oncology

基　　金：江苏省卫生厅科研项目(编号:YG201502)。

摘　　要：目的:探讨Ⅰ,Ⅱ期非小细胞肺癌(NSCLC)患者采用完全胸腔镜单向式肺叶切除术的优点。方法:回顾性分析2016年05月至2018年06月于本院就诊收治的132例Ⅰ,Ⅱ期NSCLC患者的病例资料,根据手术方法的不同进行分组,81例患者采用完全胸腔镜单向式肺叶切除术治疗分为实验组,51例患者采用开放肺叶切除术分为对照组。比较两组患者围术期一般情况、VAS评分、并发症发生情况以及生存率。结果:实验组手术时间、手术切口长度、拔管时间及住院时间均短于对照组,术中出血量、术后引流量少于对照组(P<0.05);实验组术后VAS评分低于对照组(P<0.05);实验组术后肺持续漏气、感染、房颤以及低氧血症并发症发生率低于对照组(P<0.05);术后失访3例,随访率为97.73%,随访时间2~42个月,中位随访时间为38个月。随访期间实验组、对照组死亡率分别为11.39%(9/79)、12.00%(6/50),经Log-rank检验发现两组患者生存率比较,差异无统计学意义(χ~2=0.684,P=0.485)。结论:Ⅰ,Ⅱ期非小细胞肺癌患者采用完全胸腔镜单向式肺叶切除术具有创伤小、手术操作简单、并发症少等优势。Objective:To investigate the advantages of complete thoracoscopic unilateral lobectomy in patients with stageⅠ,Ⅱnon-small cell lung cancer(NSCLC).Methods:The clinical data of 132 cases patients with stageⅠ,ⅡNSCLC admitted in our hospital from May 2016 to June 2018 were retrospectively analyzed.According to the different surgical methods,81 patients with complete thoracoscopic unilateral lobectomy were divided into experimental group.51 patients were divided into control group by open lobectomy.The general situation,VAS score,complications and survival rate of the two groups were compared.Results:The operation time,incision length,extubation time and hospitalization time of the experimental group were shorter than those of the control group,and the intraoperative blood loss and postoperative drainage volume of the experimental group were less than those of the control group(P<0.05).The VAS score of the experimental group was lower than that of the control group(P<0.05).The incidence of pulmonary continuous air leakage,infection,atrial fibrillation and hypoxemia in the experimental group was lower than that in the control group(P<0.05).3 cases were lost to follow-up.The follow-up rate was 97.73%.The follow-up time was 2~42 months.The median follow-up time was 38 months.During the follow-up period,the mortality rates of the experimental group and the control group were 11.39%(9/79)and 12.00%(6/50),respectively.There was no significant difference in the survival rate between the two groups by Log-rank test(χ~2=0.684,P=0.485).Conclusion:Complete thoracoscopic unilateral lobectomy for patients with stageⅠ,Ⅱnon-small cell lung cancer has the advantages of less trauma,simple operation and fewer complications.

关 键 词：非小细胞肺癌 完全胸腔镜单向式肺叶切除术 优点分析 

分 类 号：R734.2[医药卫生—肿瘤]