胸腔镜肺叶切除术、肺段切除术与开胸手术治疗早期肺癌的效果比较  

Comparison of the Effect of Thoracoscopic Lobectomy,Segmentectomy and Thoracotomy in the Treatment of Early Lung Cancer

作　　者：于耀洋 黄向宇 赵耀坤 YU Yaoyang;HUANG Xiangyu;ZHAO Yaokun(Department of Thoracic Surgery,Zhumadian Central Hospital,Zhumadian 463000,China)

机构地区：[1]驻马店市中心医院胸外科,河南驻马店463000

出　　处：《河南医学研究》2023年第8期1459-1463,共5页Henan Medical Research

摘　　要：目的 比较胸腔镜肺叶切除术、肺段切除术与开胸手术治疗早期肺癌的效果。方法 选取2019年8月至2022年10月驻马店市中心医院收治的135例早期肺癌患者,根据手术方法分为A组(45例,接受胸腔镜肺叶切除术)、B组(48例,接受胸腔镜肺段切除术)、C组(42例,接受传统开胸手术)。比较3组手术后的临床疗效、围手术期相关指标、肺功能检查以及并发症情况。结果 A、B组术中出血量少于C组,B组的出血量少于A组(P<0.05)。3组手术时间由短到长依次为A、B、C组,A、B两组手术时间短于C组(P<0.05),A、B两组手术时间差异无统计学意义(P>0.05)。3组手术后住院时间由短到长依次为B、A、C组,A、B两组住院时间短于C组,且B组住院时间短于A组(P<0.05)。术后A、B两组的视觉模拟评分(VAS)低于C组(P<0.05),A、B两组的VAS评分差异无统计学意义(P>0.05)。3组淋巴结清除情况差异无统计学意义(P>0.05)。手术前3组患者的肺功能差异无统计学意义(P>0.05),手术后3组用力肺活量(FVC)、每分钟最大通气量(MVV)、第1秒用力呼气容积(FEV_(1))均降低,B组肺功能优于A组,A组优于C组(P<0.01)。A、B组的治疗有效率高于C组,B组治疗有效率高于A组(P<0.05)。A、B组并发症发生率低于C组(P<0.05),A组与B组并发症发生率差异无统计学意义(P>0.05)。结论 与开胸手术相比,胸腔镜手术治疗早期肺癌的疗效佳,手术时间、住院时间短,术中出血量较少,术后疼痛程度较轻,术后肺功能影响更小,术后并发症较少;胸腔镜肺段切除术疗效优于肺叶切除术,术中出血量少,住院时间短,能够更好地保留肺功能。Objective To compare the effectiveness of thoracoscopic lobectomy,segmental resection,and thoracotomy in the treatment of early lung cancer.Methods A total of 135 early lung cancer patients admitted to Zhumadian Central Hospital from August 2019 to October 2022 were selectd,according to the surgical method,they were divided into group A(45 cases,receiving thoracoscopic lobectomy),group B(48 cases,receiving thoracoscopic segmental resection),and group C(42 cases,receiving traditional thoracotomy).The clinical efficacy,perioperative related indicators,lung function detection and complications after surgery were compared among the three groups.Results The intraoperative blood loss in groups A and B was less than that in group C,and the blood loss in group B was less than that in group A(P<0.05).The surgical time of the three groups was successively shown as group A,group B and group C in the order form short to long,the surgical time of group A or group B was shorter than that of group C(P<0.05),and there was no statistical difference between group A and group B(P>0.05).The hospital stay of the three groups after surgery was from shortest to longest in groups B,A and C.The hospital stay in group A and group B was shorter than that in group C,and the hospital stay in group B was shorter than that in group A(P<0.05).The score of visual analogue scale(VAS)of group A and group B was lower than that of group C(P<0.05),but the VAS scores of group A and group B with no statistical differences(P>0.05),and there was no statistical difference in lymph node dissection in the three groups(P>0.05).There was no statistically difference in lung function among the three groups of patients before surgery(P>0.05).After surgery,the forced vital capacity(FVC),maximal voluntary ventilation(MVV),forced expiratory volume in one second(FEV_(1))were significantly decreased in the three groups,the lung function was better in group B than group A and better in group A than group C(P<0.05).The effective rate of group A and group B was better t

关 键 词：胸腔镜 肺叶切除术 肺段切除术 开胸手术 肺癌 

分 类 号：R734.2[医药卫生—肿瘤]