胸腔镜辅助小切口肺癌根治术与肺楔形切除术治疗肺癌预后及对肺功能的影响  

Thoracoscope assisted small incision lung cancer treated with thoracoscopy pulmonary wedge resection in treatment of lung cancer prognosis

作　　者：陈伟华 李玮浩[2] 王君[1] 肖阳[1] 池玉杰 CHEN Wei-hua;LI Wei-hao;WANG Jun;XIAO Yang;CHI Yu-jie(Department of Day Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Thoracic Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院日间手术部,郑州450052 [2]郑州大学第一附属医院胸外科,郑州450052

出　　处：《医药论坛杂志》2024年第10期1019-1023,共5页Journal of Medical Forum

摘　　要：目的 研究肺癌采用胸腔镜辅助小切口肺癌根治术与胸腔镜肺楔形切除术治疗的预后效果及对肺功能的影响。方法 选取2021年2月—2022年4月郑州大学第一附属医院胸外科收治的86例肺癌患者,以手术方案为依据进行分组,胸腔镜辅助下实施小切口肺癌根治术的43例作为对照组,胸腔镜下行肺楔形切除术的43例作为研究组,对比两组手术相关指标、肺功能、预后疗效以及并发症情况。结果 研究组手术时间、术后拔管时间和住院时间为(140.32±12.78)min、(4.23±1.07)d和(6.22±0.85)d,均短于对照组(P<0.05),术中出血量为(129.57±10.59)mL,少于对照组(P<0.05),术后72 h视觉模拟评分法(VAS)评分(3.02±0.61)分,低于对照组(P<0.05);两组术前肺功能指标比较无统计学意义(P>0.05),研究组术后用力肺活量(forced vital capacity, FVC)(2.11±0.67)L、最大呼气流量(peak expiratory flow, PEF)(3.55±0.96)L/s以及第一秒用力呼气量(forced expiratory volume in first second, FEV1)(1.61±0.55)L,均高于对照组(P<0.05);研究组治疗总有效率95.35%,与对照组97.67%比较无统计学意义(P>0.05);研究组术后并发症发生率6.98%,与对照组9.30%比较无意义(P>0.05)。结论 肺癌患者给予胸腔镜辅助小切口肺癌根治术或胸腔镜肺楔形切除术安全性无差异,均能取得良好预后,但楔形切除术更有利于术后快速恢复,对肺功能影响更小,疼痛更轻,创伤更小,临床可合理选择。Objective To study the effect of resection radical assisted thoracoscopic of lung cancer and thoracoscopic wedge-shaped resection on lung function.Methods A total of 86 patients with lung cancer admitted to the Department of Thoracic Surgery of our hospital from February 2021 to April 2022 were selected and divided into groups according to the surgical plan. 43 cases of thoracoscopic radical resection of lung cancer with small incision were taken as the control group, and 43 cases of thoracoscopic wedge-shaped resection of lung were taken as the study group. The surgical indicators, lung function, prognostic efficacy and complications of the two groups were compared.Results The operation time, postoperative extubation time and hospital stay of the study group were(140.32±12.78) min,(4.23±1.07) d and(6.22±0.85) d, all of which were shorter than those of the control group(P<0.05), and the intraoperative blood loss was(129.57±10.59) mL, which was less than that of the control group(P<0.05). The score of 72hVAS(3.02±0.61) after operation was lower than that of control group(P<0.05). There was no statistical significance in preoperative pulmonary function indexes between the two groups(P>0.05). FVC(2.11±0.67) L, PEF(3.55±0.96) L/s and FEV1(1.61±0.55) L in study group were higher than those in group control(P<0.05). The total effective rate of the study group was 95.35%, which was not statistically significant compared with 97.67% of the control group(P>0.05). The incidence of postoperative complications in the study group was 6.98%, compared with 9.30% in the control group(P>0.05).Conclusion There is no difference in safety between thoracoscopic assisted radical resection of lung cancer with small incision or thoracoscopic wedge-resection for lung cancer patients, both of which can achieve a good prognosis. However, wedge-resection is more conducive to rapid postoperative recovery, with less impact on lung function, less pain and less trauma, and can be a reasonable choice clinically.

关 键 词：胸腔镜 小切口肺癌根治术 肺楔形切除术 肺癌 预后 

分 类 号：R734.2[医药卫生—肿瘤]