胸腔镜肺叶切除术与肺段切除术治疗早期肺癌的效果对比  

Comparison of effect of thoracoscopic lobectomy and segmentectomy in the treatment of early-stage lung cancer

作　　者：肖中岳[1] 乔滨[1] 陈乐乐 Xiao Zhongyue;Qiao Bin;Chen Lele(Department of Lung Oncology Surgery,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院肺肿瘤外科,洛阳471000

出　　处：《中国实用医刊》2022年第23期6-9,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨胸腔镜肺叶切除术与肺段切除术治疗早期肺癌的临床效果。方法抽取2020年1月至2021年8月河南科技大学第一附属医院收治的早期肺癌患者104例,按随机数字表法分为肺段切除组与肺叶切除组,每组52例。肺叶切除组采用胸腔镜肺叶切除术,肺段切除组采用胸腔镜肺段切除术。对比两组围术期情况、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、癌胚抗原(CEA)、细胞角蛋白19的可溶性片段(CYFRA21-1)、C-反应蛋白(CRP)及并发症发生率。结果肺段切除组术中出血量少于肺叶切除组,住院时间短于肺叶切除组(P<0.05);术后6个月,两组FVC、FEV1水平低于术前,肺段切除组FVC、FEV1水平高于肺叶切除组(P<0.05);术后6个月,肺段切除组CEA、CYFRA21-1水平低于肺叶切除组(P<0.05);术后1、3 d,肺段切除组CRP水平低于肺叶切除组(P<0.05);肺段切除组并发症发生率(7.69%,4/52)与肺叶切除组(13.46%,7/52)比较差异未见统计学意义(P>0.05)。结论与胸腔镜肺叶切除术比较,胸腔镜肺段切除术治疗早期肺癌可改善围术期情况和肺功能,降低肿瘤标志物水平,减轻术后炎性反应,且安全性良好。Objective To investigate the clinical effect of thoracoscopic lobectomy and segmentectomy in the treatment of early-stage lung cancer.Methods A total of 104 patients with early-stage lung cancer treated in the First Affiliated Hospital of Henan University of Science and Technology from January 2020 to August 2021 were selected,and they were divided into segmentectomy group and lobectomy group according to random number table method,with 52 cases in each group.The lobectomy group was treated by thoracoscopic lobectomy,and the segmentectomy group was treated by thoracoscopic segmentectomy.The perioperative conditions,forced vital capacity(FVC),forced expiratory volume in 1 second(FEV1),carcinoembryonic antigen(CEA),soluble fragment of cell keratin 19(CYFRA21-1),C-reactive protein(CRP)and complications were compared between the two groups.Results The intraoperative blood loss in the segmentectomy group was less than that in the lobectomy group,and the hospital stay was shorter than that in the lobectomy group(P<0.05).Six months after operation,the levels of FVC and FEV1 in the two groups were lower than those before operation,and the levels of FVC and FEV1 in the segmentectomy group were higher than those in the lobectomy group(P<0.05).Six months after operation,the levels of CEA and CYFRA21-1 in the segmentectomy group were lower than those in the lobectomy group(P<0.05).One day and 3 days after operation,the CRP level in the segmentectomy group was lower than that in the lobectomy group(P<0.05).There was no significant difference in the incidence of complications between the segmentectomy group(7.69%,4/52)and the lobectomy group(13.46%,7/52),P>0.05.Conclusions Compared with thoracoscopic lobectomy,thoracoscopic segmentectomy in the treatment of early-stage lung cancer can improve the perioperative condition and lung function,reduce the level of tumor markers,reduce postoperative inflammatory reaction,with good safety.

关 键 词：肺癌 早期 胸腔镜肺叶切除术 肺段切除术 

分 类 号：R734.2[医药卫生—肿瘤]