非小细胞肺癌术应用侧卧位手部体位垫对患者肿瘤微转移、创伤反应的影响  

Effect of lateral decubitus hand position pad on tumor micrometastasis and trauma response in patients with non-small cell lung cancer

作　　者：李娜 刘晓娣 Li Na;Liu Xiaodi(Department of Surgical Oncology,Zhejiang Jinhua Guangfu Cancer Hospital,Jinhua 321000,China)

机构地区：[1]浙江金华广福肿瘤医院胸部肿瘤外科,金华321000

出　　处：《中国医师进修杂志》2024年第10期912-916,共5页Chinese Journal of Postgraduates of Medicine

基　　金：金华市科技计划项目(20224211)。

摘　　要：目的分析单孔胸腔镜非小细胞肺癌根治术应用侧卧位手部体位垫对患者肿瘤微转移、创伤反应的影响。方法回顾性选取浙江金华广福肿瘤医院2020年1月至2022年1月收治的78例非小细胞肺癌患者(Ⅰ期45例,Ⅱ期33例)为研究对象,均行单孔胸腔镜非小细胞肺癌根治术,依照体位摆放方法分为对照组(38例,采用传统体位摆放)和研究组(40例,采用侧卧位手部体位垫)。比较两组体位相关指标和手术前后转移基因表达量、肿瘤标志物水平及应激反应指标水平。结果研究组体位摆放一次成功率高于对照组[100.00%(40/40)比78.95%(30/38)],手术皮肤受压率及肢体不适率低于对照组[2.50%(1/40)比26.32%(10/38)、5.00%(2/40)比28.95%(11/38)],体位摆放时间短于对照组[(8.47±1.38)min比(12.42±2.03)min],差异均有统计学意义(P<0.05)。研究组术后3个月肿瘤坏死因子受体相关蛋白1、基质金属蛋白酶-9表达量低于对照组(0.56±0.07比0.85±0.10、0.32±0.04比0.54±0.06),钙黏附蛋E、Krüppel样因子4表达量高于对照组(1.69±0.22比1.36±0.17、2.25±0.37比1.98±0.20),差异有统计学有意义(P<0.05)。研究组术后3个月癌胚抗原、细胞角质蛋白水平低于对照组[(36.89±4.12)μg/L比(41.72±5.34)μg/L、(7.25±0.81)μg/L比(8.01±1.34)μg/L],差异有统计学有意义(P<0.05)。研究组术后1 d前列腺素E2、皮质醇、P物质水平低于对照组[(110.47±10.12)pg/L比(138.88±14.42)pg/L、(60.37±7.18)ng/L比(71.34±8.01)ng/L、(6.26±0.81)μg/L比(8.25±1.17)μg/L],差异有统计学意义(P<0.05)。结论单孔胸腔镜非小细胞肺癌根治术中应用侧卧位手部体位垫可改善患者体位摆放效果,提升手术效果,从而减轻创伤反应,有效抑制肿瘤微转移。Objective To analyze the effect of lateral decubitus hand position pad on tumor micrometastasis and trauma response in patients with non-small cell lung cancer.Methods Seventy-eight patients with non-small cell lung cancer(45 patients in stageⅠ,and 33 cases in stageⅡ)admitted to Zhejiang Jinhua Guangfu Cancer Hospital from January 2020 to January 2022 and performed single-aperture thoracoscopic radical resection of non-small cell lung cancer was retrospectively selected,and they were divided into control group(38 cases,adopted traditional body positioning)and study group(40 cases,adopted lateral decubitus hand position pad).Postural indicators,expression levels of metastatic genes,tumor markers,pain degree and stress response indicators were compared between the two groups.Results The success rate of one position placement in the study group was higher than that in the control group:100.00%(40/40)vs.78.95%(30/38);the incidence of surgical skin compression and limb discomfort were lower than those in the control group:2.50%(1/40)vs.26.32%(10/38),5.00%(2/40)vs.28.95%(11/38);the position placement time was short than that in the control group:(8.47±1.38)min vs.(12.42±2.03)min,there were statistical differences(P<0.05).Three months after surgery,the expressions of tumor necrosis factor receptor-associated protein 1(TRAP1),matrix metalloproteinase-9(MMP-9)in the study group were lower than those in the control group:0.56±0.07 vs.0.85±0.10,0.32±0.04 vs.0.54±0.06,the expressions of E-cadherin and Kruppel-like factor 4(KLF4)in the study group were higher than those in the control group:1.69±0.22 vs.1.36±0.17,2.25±0.37 vs.1.98±0.20,there were statistical differences(P<0.05).Three months after surgery,the levels of carcinoembryonic antigen(CEA),cytokeratin(CYFRA21-1)in the study group were lower than those in the control group:(36.89±4.12)μg/L vs.(41.72±5.34)μg/L,(7.25±0.81)μg/L vs.(8.01±1.34)μg/L,there were statistical differences(P<0.05).At 1-day after surgery,the levels of prostaglandin E2(PGE2),co

关 键 词：癌 非小细胞肺 肿瘤微转移 侧卧位 手部体位垫 应激障碍 创伤性 

分 类 号：R734.2[医药卫生—肿瘤]