单孔胸腔镜手术对老年NSCLC患者氧化损伤和外周血NE、Cor及IMA水平的影响  

Effects of single-port thoracoscopic surgery on oxidative injury,peripheral blood NE,Cor and IMA in elderly patients with NSCLC

作　　者：罗业春[1] LUO Yechun(Department of Cardiothoracic Surgery,Yulin Red Cross Hospital,Yulin 537000,China)

机构地区：[1]玉林市红十字会医院心胸外科,广西玉林537000

出　　处：《中国医学物理学杂志》2023年第9期1156-1160,共5页Chinese Journal of Medical Physics

基　　金：广西壮族自治区卫计委科研项目(Z20200324)。

摘　　要：目的:探讨单孔胸腔镜手术对老年非小细胞肺癌(NSCLC)患者氧化损伤和外周血去甲肾上腺素(NE)、皮质醇(Cor)及缺血修饰白蛋白(IMA)水平的影响。方法:选取94例老年NSCLC患者,根据其手术方式分为单孔组(n=46,单孔胸腔镜手术)和三孔组(n=48,传统三孔胸腔镜手术)。收集两组患者手术及实验室相关资料,比较两组患者手术相关指标,手术前后血清疼痛介质指标(NE、Cor)和IMA、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)]、炎性因子[白细胞介素(IL)-6、IL-8、C反应蛋白(CRP)、肿瘤坏死因子(TNF)-α]水平变化及并发症情况。结果:两组术中出血量和淋巴结清扫数目比较差异无统计学意义(P>0.05)。单孔组手术时间长于三孔组,住院时间短于三孔组(P<0.05);单孔组术后血清NE、Cor、IMA、MDA、IL-6、IL-8、CRP、TNF-α水平低于三孔组,血清SOD高于三孔组(P<0.05);单孔组术后并发症发生率为4.55%,低于三孔组的19.75%(P<0.05)。结论:NSCLC患者胸腔镜手术采用单孔操作创伤小,可有效减轻疼痛应激和氧化损伤、降低炎性反应及并发症风险,更有利于患者术后恢复,且可获得与三孔一致的手术效果。Objective To explore the effects of single-port thoracoscopic surgery on the oxidative injury and the norepinephrine(NE),cortisol(Cor)and ischaemic modified albumin(IMA)in peripheral blood of elderly patients with nonsmall cell lung cancer(NSCLC).Methods According to surgical procedures,94 elderly patients with NSCLC were divided into single-port group(n=46,single-port thoracoscopic surgery)and three-port group(n=48,traditional three-port thoracoscopic surgery).The surgical and laboratory data in both two groups were collected.The surgery-related indexes,changes in levels of serum pain mediators(NE,Cor)and IMA,oxidative stress indexes[superoxide dismutase(SOD),malondialdehyde(MDA)]and inflammatory factors[interleukin-6(IL-6),IL-8,C-reactive protein(CRP),tumor necrosis factorα(TNF-α)]before and after surgery,and incidence of complications were compared between two groups.Results There was no significant difference in intraoperative blood loss or number of lymph nodes dissection between two groups(P>0.05).The patients in single-port group had longer operative duration but short hospital stay than those in three-port group(P<0.05).After surgery,the levels of NE,Cor,IMA,MDA,IL-6,IL-8,CRP and TNF-αin single-port group were lower than those in three-port group,while the level of SOD was higher than that in three-port group(P<0.05).The total incidence of postoperative complications in single-port group was 4.55%,lower than 19.75%in three-port group(P<0.05).Conclusion Single-port thoracoscopic surgery is less traumatic in NSCLC patients,and it can effectively relieve pain stress and oxidative injury,reduce risks of inflammatory response and complications,and is more conducive to postoperative recovery,with the same surgical efficacy as compared with three-port thoracoscopic surgery.

关 键 词：胸腔镜 单孔 非小细胞肺癌 老年 氧化损伤 疼痛应激 

分 类 号：R655.3[医药卫生—外科学]