胸腔镜下肺段切除与肺叶切除对早期肺癌患者疗效及生活质量的影响  

Impact of thoracoscopic segmental resection and lobectomy on the efficacy andquality of life of early lung cance

作　　者：王腾飞[1] 耿玉六[1] 徐明 王博 张源源 Wang Tengfei;Geng Yuliu;Xu Ming(External Thoracic and Vascular Surgery,North Anhui Coal Power Group General Hospital,Suzhou 234000,China)

机构地区：[1]皖北煤电集团总医院胸外与血管外科,宿州234000

出　　处：《中华保健医学杂志》2024年第5期618-621,共4页Chinese Journal of Health Care and Medicine

基　　金：宿州市科技计划项目(SZSKJJZC056)。

摘　　要：目的对比胸腔镜下肺段切除与肺叶切除在早期肺癌患者治疗中的应用价值,以及对患者生活质量的影响。方法选取皖北煤电集团总医院2021年1月~2023年11月收治的103例早期肺癌患者,随机数表法分为观察组和对照组,观察组(n=51)患者接受胸腔镜下肺段切除术治疗,对照组(n=52)患者则接受胸腔镜下肺叶切除术治疗。比较两组患者围术期指标;比较两组患者术前、术后1月肺功能指标[用力肺活量(FVC)、第1 s用力呼气容积(FEV1)]变化;比较两组患者生活质量指标[肺癌治疗功能性量表(FACT-L)评分]的变化;记录随访半年时复发及死亡情况。结果观察组手术时间及引流管留置时间分别为(127.32±20.38)min,(4.39±1.63)d,明显短于对照组的(153.15±32.61)min,(5.54±2.89)d;引流量为(645.82±122.51)ml,显著少于对照组的(947.53±180.87)ml,差异均有统计意义(t=4.810、9.893、2.485,P<0.05)。两组患者术中出血量、淋巴结清扫数量比较,差异无统计学意义(P>0.05);术后住院时间、并发症发生率差异亦无统计学意义(P>0.05)。与术前比较,术后两组患者肺功能指标FVC、FEV1均有所降低,但是与对照组比较,观察组降低程度较小,差异有统计学意义(P<0.05)。术后,观察组患者FACT-L量表中情感及功能状态、总分分别为(17.21±3.94)分、(19.08±3.61)分、(104.39±9.64)分,明显高于对照组的(14.15±2.49)分、(17.17±2.24)分、(97.97±8.22)分,差异均有统计意义(t=4.561、3.233、3.639,P<0.05)。术后随访6月,两组均无死亡与复发病例。结论对于早期肺癌的治疗,胸腔镜下肺段切除与肺叶切除术均具有较好的疗效,但是肺段切除术患者的术后恢复快,更有利于肺功能的保护及生活质量的改善。Objective To compare the effects of thoracoscopic segmental resection and lobectomy on the efficacy and quality of life of early lung cancer.Methods One hundred and three early-stage lung cancer patients were randomly divided into two groups,from January 2021 to November 2023,treated in our hospital,the observation group(n=51)received thoracoscopic segmental resection treatment,and the control group(n=52)received thoracoscopic lobectomy treatment.The perioperative indicators between the two groups were compared,as were the changes in preoperative and postoperative lung function indicators(FVC%,FEV1)and quality of life indicators(FACT-L score)at 1 month.The recurrence and mortality during the six-month follow-up were recorded.Results The surgical time and drainage tube retention time of the observation group were(127.32±20.38)min and(4.39±1.63)d,respectively,significantly shorter than the control group's(153.15±32.61)min and(5.54±2.89)d.The drainage volume was(645.82±122.51)ml,significantly less than the control group's(947.53±180.87)ml,and the differences were statistically significant(t=4.810,9.893,2.485,P<0.05).There was no significant difference in intraoperative bleeding and lymph node dissection number between the two groups,nor in postoperative hospital stay and complication rates(P>0.05).After surgery,the lung function indicators FVC and FEV1 in both groups decreased,but the decrease was less in the observation group compared to the control group,with a statistically significant difference(P<0.05).After surgery,the emotional and functional status and total score of the FACT-L scale in the observation group were significantly higher than those in the control group,with statistically significant differences(t=4.561,3.233,3.639,P<0.05).After six months of postoperative follow-up,there were no deaths or recurrences in either group.Conclusion For the treatment of early lung cancer,both thoracoscopic segmentectomy and lobectomy have good therapeutic effects.Patients undergoing segmentectomy have faster pos

关 键 词：早期肺癌 胸腔镜 肺段切除术 肺叶切除术 生活质量 

分 类 号：R734[医药卫生—肿瘤]