保留迷走神经肺支对Ⅰ期周围型肺腺癌患者术后咳嗽影响的初步研究  

Effect of Preserving the Pulmonary Branch of Vagus Nerve on Postoperative Cough in Patients with Stage Ⅰ Peripheral Lung Adenocarcinoma

作　　者：王高祥 陈郑玮 吴明胜 李田[1] 孙效辉 徐美青 解明然 Gaoxiang WANG;Zhengwei CHEN;Mingsheng WU;Tian LI;Xiaohui SUN;Meiqing XU;Mingran XIE(Department of Thoracic Surgery,The First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,China)

机构地区：[1]中国科学技术大学附属第一医院胸外科,合肥230001

出　　处：《中国肺癌杂志》2024年第2期102-108,共7页Chinese Journal of Lung Cancer

基　　金：国家自然科学基金项目(No.81973643);安徽省自然科学基金项目(No.2308085MH296)资助。

摘　　要：背景与目的咳嗽是肺部手术后的主要并发症之一,严重影响患者术后生活质量。保留迷走神经肺支可能降低患者术后咳嗽发生率。因此,本研究旨在探究保留迷走神经肺支是否能够降低I期肺腺癌患者术后慢性咳嗽发生率。方法前瞻性选取2022年6月至2023年6月于中国科学技术大学附属第一医院胸外科行单孔胸腔镜肺癌根治术患者125例,根据术中是否保留迷走神经肺支分为保留迷走神经肺支组(n=61)和传统组(n=64)。记录两组患者一般临床资料、围手术期情况、淋巴结清扫情况、术前及术后8周中文版莱斯特咳嗽问卷(Mandarin Chinese version of the Leicester Cough Questionnaire,LCQ-MC)评分。将两组患者根据术中淋巴结清扫后是否填塞自体脂肪或吸收性明胶海绵分为填塞组及非填塞组,比较两组亚组间LCQ-MC评分及术后慢性咳嗽情况。结果传统组术后8周LCQ-MC评分在生理、心理、社会及总分方面明显低于保留迷走神经肺支组,差异均有统计学意义(P<0.05);咳嗽患者较保留迷走神经肺支组更多(P=0.006)。保留迷走神经肺支组和传统组分别进行亚组分析,保留迷走神经肺支组患者和传统组患者中,非填塞组术后8周LCQ-MC评分均低于填塞组(P<0.05),非填塞组术后8周咳嗽患者均较填塞组更多(P=0.001,P=0.024)。结论对于I期周围型肺腺癌患者行手术治疗时,保留迷走神经肺支安全有效,能够降低患者术后慢性咳嗽发生率,提高患者术后生活质量。Background and objective Cough is one of the main complications after pulmonary surgery,which seriously affects the postoperative quality of life.Preserving the pulmonary branch of vagus nerve may reduce the incidence of postoperative cough.Therefore,the aim of this study was to investigate whether preserving the pulmonary branch of the vagus nerve could reduce the incidence of postoperative chronic cough in patients with stage I peripheral lung adenocarcinoma.Methods A total of 125 patients who underwent single-port thoracoscopic radical resection for lung cancer in the Department of Thoracic Surgery,The First Affiliated Hospital of University of Science and Technology of China from June 2022 to June 2023 were retrospectively selected,and divided into two groups according to whether the vagopulmonary branch was preserved during the operation,namely,the vagopulmonary branch group(n=61)and the traditional group(n=64).The general clinical data,perioperative conditions,lymph node dissection,Mandarin Chinese version of The Leicester Cough Questionnaire(LCQ-MC)scores before and 8 weeks after operation were recorded in the two groups.Both the two groups were divided into tamponade group and non-tamponade group according to whether autologous fat or gelatin sponge was tamponade after lymph node dissection.LCQ-MC scores and postoperative chronic cough of both groups were calculated.Results The LCQ-MC score of the traditional group was significantly lower than that of the vagopulmonary branch group in physiological,psychological,social and total scores at 8 weeks after surgery,and the difference was statistically significant(P<0.05).There were more cough patients in the traditional group than the vagopulmonary branch group at 8 weeks after surgery,with significant difference(P=0.006).Subgroup analysis was conducted separately for the vagopulmonary branch group and the traditional group.Among the patients in the vagopulmonary branch group and the traditional group,the LCQ-MC scores of the non-tamponade group 8 weeks after

关 键 词：肺肿瘤 迷走神经 咳嗽 中文版莱斯特咳嗽量表 

分 类 号：R734.2[医药卫生—肿瘤]