基于倾向性评分匹配法比较微创解剖性肺段和肺叶切除术对早期非小细胞肺癌患者术后肺功能的影响  

Comparison of effects of minimally invasive anatomical segmentectomy and lobectomy on postoperative pulmonary function in patients with early-stage non-small cell lung cancer based on PSM method

作　　者：靳妍玉 汪赵艳 韩李周[1] 陈新涛[1] JIN Yan-yu;WANG Zhao-yan;HAN Li-zhou;CHEN Xin-tao(Jiaozuo People's Hospital,Jiaozuo,Henan 454002,China)

机构地区：[1]焦作市人民医院肺功能室,河南焦作454002

出　　处：《医药论坛杂志》2023年第21期69-71,共3页Journal of Medical Forum

摘　　要：目的基于倾向性评分匹配(propensity score matching,PSM)法均衡基线资料后比较微创解剖性肺段和肺叶切除术对早期非小细胞肺癌患者术后肺功能的影响。方法回顾性纳入2016年1月—2022年1月于焦作市人民医院行胸腔镜手术治疗早期非小细胞肺癌患者共294例,根据术式划分为肺段组(164例)和肺叶组(130例),分别采用解剖性肺段和肺叶切除术治疗;采用PSM法均衡性别、年龄、肿瘤位置、吸烟史及BMI等基线特征指标后,两组各纳入患者95例;比较两组基线临床病理资料和手术前后肺功能指标水平。结果匹配后肺叶组肿瘤最大径和切除淋巴结数量均显著多于肺段组(P<0.05);肺叶组术后住院时间显著长于肺段组(P<0.05);两组术前肺功能指标和术后3个月肺功能改善情况比较差异无统计学意义(P>0.05);肺叶组术后6个月肺功能改善情况显著优于肺段组(P<0.05)。结论微创解剖性肺叶切除术相较于肺段切除术更有助于保护早期非小细胞肺癌患者术后肺功能。Objective The effects of minimally invasive anatomical segmentectomy and lobectomy on postoperative lung function in patients with early-stage non-small cell lung cancer were compared after balancing baseline data based on propensity score matching(PSM).Methods A total of 294 patients with early-stage non-small cell lung cancer who underwent thoracoscopic surgery in Jiaozuo People's Hospital from January 2016 to January 2022 were retrospectively included.Patients were treated with anatomic segmentectomy and lobectomy,respectively.After balancing baseline characteristics such as gender,age,tumor location,smoking history,and BMI using the PSM method,95 patients in each group were included.Baseline clinicopathological data and pulmonary function index levels before and after surgery were compared between the two groups.Results After matching,the maximum tumor diameter and the number of resected lymph nodes in the lobe group were significantly higher than those of the segment group(P<0.05);The postoperative hospital stay in the lobe group was significantly longer than that of the segment group(P<0.05);There was no significant difference in the preoperative pulmonary function indexes and the improvement of pulmonary function 3 months after operation between the two groups(P>0.05);The improvement of lung function in the lobe group at 6 months after surgery was significantly better than that of the segment group(P<0.05).Conclusion Compared with segmentectomy,minimally invasive anatomical lobectomy is more helpful in protecting postoperative lung function in patients with early-stage non-small cell lung cancer.

关 键 词：肺段切除术 肺叶切除术 肺癌 胸腔镜 肺功能 

分 类 号：R734.2[医药卫生—肿瘤]