160例双孔全胸腔镜肺叶切除术在早期肺癌治疗中的应用  

Application of double aperture total thoracoscopic lobectomy in the treatment of early lung cancer in 160 cases

作　　者：吴衷平 卢积榕 李永旺[1] 王东华[1] 郑石勇 杨建评 潘小杰[2] Wu Zhongping;Lu Jirong;Li Yongwang;Wang Donghua;Zheng Shiyong;Yang Jianping;Pan Xiaojie(Sanming Integrated Medicine Hospital,Sanming 365001,China;Department of Thoracic Surgery,Fujian Provincial Hospital,Fuzhou 350013,China)

机构地区：[1]三明市中西医结合医院,三明365001 [2]福建省立医院胸外科,福州350013

出　　处：《中华实验外科杂志》2023年第8期1615-1618,共4页Chinese Journal of Experimental Surgery

摘　　要：目的探讨160例双孔全胸腔镜肺叶切除术在早期肺癌治疗中的应用价值。方法选取2020年1月至2022年12月的160例早期肺癌患者作为对照组, 行开胸肺叶切除术治疗, 另选取同一时间段内的160例早期肺癌患者作为研究, 行双孔全胸腔镜肺叶切除术治疗, 比较两组术后不同时点的疼痛程度, 比较两组手术相关指标, 比较两组并发症发生情况。采用t检验比较两组术后不同时点的疼痛程度以及手术相关指标, 采用卡方检验比较两组并发症发生。结果对照组术后24、72 h的疼痛评分为(6.38±0.37)、(4.56±0.24)分, 研究组术后24、72 h时的疼痛评分为(5.91±0.32)、(2.93±0.12)分, 术后24、72 h时的疼痛评分, 研究组均更低于对照组(t=12.153、38.420, P<0.05);对照组流管留置时间、淋巴结清扫数目为(3.70±1.04) d、(12.57±1.87)组, 研究组流管留置时间、淋巴结清扫数目为(3.48±1.13) d、(12.77±1.75)组, 两组间引流管留置时间、淋巴结清扫数目对比差异无统计学意义(t=1.812、0.988, P>0.05), 但研究组住院时间、术中出血量、手术时间[(2.97±1.31) d、(98.65±9.32) ml、(144.93±12.56) min]均少于对照组[(7.99±1.74) d、(127.12±12.30) ml、(183.85±17.13) min, t=29.154、23.336、23.177, P<0.05];研究组肺部感染、肺不张、心律失常、切口感染合计并发症发生率(6.3%)低于对照组(23.8%, χ2=9.608, P<0.05)。结论双孔全胸腔镜肺叶切除术治疗早期肺癌患者, 相较于开胸肺叶切除术治疗, 患者术后疼痛感更低, 住院时间、手术时间更短, 并发症发生率更小, 加速患者的术后恢复是有效且安全的治疗手段。Objective To investigate the applied value of double aperture total thoracoscopic lobectomy in the treatment of early lung cancer in 160 cases.Methods A total of 160 patients with early lung cancer from January 2020 to December 2022 were selected as the control group to receive open thoracotomy,and 160 patients with early lung cancer in the same period were selected as the study group to receive double-hole thoracoscopic lobectomy.The pain degree at different time points after surgery,and the operation-related indicators were compared between the two groups.The incidence of complications was compared between the two groups.T-test was used to compare the pain degree and operation related indicators at different time points between the two groups,and Chi-squared test was used to compare the complications of the two groups.Results The pain scores in the control group at 24 h and 72 h after surgery were(6.38±0.37)points and(4.56±0.24)points,and those in the study group at 24 h and 72 h after surgery were(5.91±0.32)points and(2.93±0.12)points.As compared with the control group,the pain scores in the study at 24 h and 72 h after surgery were declined(t=12.153,38.420,P<0.05).The retention time and lymph node dissection number in the control group[(3.70±1.04)d,(12.57±1.87)],and the study group[(3.48±1.13)d,(12.77±1.75)]showed no significant difference(t=1.812,0.988,P>0.05).The hospital stay,intraoperative blood loss and operation time in the study group[(2.97±1.31)d,(98.65±9.32)ml,(144.93±12.56)min]were decreased as compared with those in the control group[(7.99±1.74)d,(127.12±12.30)ml,(183.85±17.13)min,t=29.154,23.336,23.177,P<0.05].The combined complication rate of pulmonary infection,attasis,arrhythmia and incision infection in the study group(6.3%)was lower than that in the control group(23.8%,χ2=9.608,P<0.05).Conclusion Compared with open pulmonary lobectomy,double-hole thoracoscopic lobectomy can reduce postoperative pain,shorten hospital stay and operation time,reduce complication rate and accelerat

关 键 词：早期肺癌 双孔全胸腔镜肺叶切除术 疼痛 并发症 恶性肿瘤 

分 类 号：R734.2[医药卫生—肿瘤]