胸腔镜下肺叶切除和肺段切除术对肺部恶性疾病患者术后并发症、肺功能及疼痛程度的影响  

Effect of thoracoscopic lobectomy and segmentectomy on postoperative complications,lung function,and pain in patients with malignant lung diseases

作　　者：周浩 胡青 杨洋 林永德 周叶枫 林生荣 陈超 周晟劼 ZHOU Hao;HU Qing;YANG Yang;LIN Yongde;ZHOU Yefeng;LIN Shengrong;CHEN Chao;ZHOU Chengjie(Department of Cardiothoracic Surgery,the Affiliated Dongtai Hospital of Nantong University,Yancheng,Jiangsu 224200,China)

机构地区：[1]南通大学附属东台医院胸心外科,江苏盐城224200

出　　处：《临床肺科杂志》2024年第12期1887-1891,1896,共6页Journal of Clinical Pulmonary Medicine

摘　　要：目的比较胸腔镜下肺叶切除和胸腔镜下肺段切除对肺部恶性疾病患者术后并发症、肺功能及疼痛程度的影响。方法纳入2019年8月至2023年8月在江苏省东台市人民医院住院的肺部恶性疾病患者80例,按照随机数字表法分成肺段切除组和肺叶切除组,每组各40例患者。分析两组手术前后围手术期相关指标、肺功能指标、疼痛程度及并发症。结果两组患者手术时长和术后引流量相比差异无统计学意义(P>0.05);术中失血量相比,肺叶切除组较肺段切除组明显减少(P<0.05);但住院时长相比,肺段切除组较肺叶切除组明显减少(P<0.05)。术后6个月时,肺段切除组肺功能指标FEV_(1)、FVC、VC、MVV均优于肺叶切除组,差异对比显著(P<0.05)。两组VAS评分手术前对比差异无统计学意义(P>0.05);术后1天、3天、7天对比,肺段切除组评分低于肺叶切除组(P<0.05)。两组术后并发症发生率相比差异无统计学意义(P>0.05)。结论胸腔镜下肺段切除术与肺叶切除术的安全性较高,且肺段切除术近期疗效显著,术后恢复快,尤其在术后肺功能保护方面存在着良好的优势。Objective To compare the effect of thoracoscopic lobectomy and thoracoscopic segmental resection on postoperative complications,lung function,and pain levels in patients with malignant lung diseases.Methods 80 patients with pulmonary malignant diseases who were hospitalised in Dongtai People′s Hospital of Jiangsu Province from August 2019 to August 2023 were included and divided into the lung segmental resection group and the lobectomy group according to the random number table method,with 40 patients in each group.Perioperative related indexes,lung function indexes,pain degree and complications before and after surgery were analyzed in the two groups.Results There was no significant difference in the duration of surgery and postoperative drainage compared between the two groups(P>0.05).Intraoperative blood loss was significantly reduced in the lobectomy group compared with the pulmonary segmental resection group(P<0.05).However,the duration of hospitalization was significantly reduced in the pulmonary segmental resection group compared with the pulmonary lobectomy group(P<0.05).6 months after surgery,the lung function indexes FEV_(1),FVC,VC and MVV were better in the pulmonary segmentectomy group than in the lobectomy group,and the difference was significant in comparison(P<0.05).There was no difference in VAS scores between the two groups before surgery(P>0.05).The scores of the lung segmentectomy group were lower than those of the lobectomy group when compared at 1d,3d and 7d after surgery(P<0.05).There was no significant difference in the postoperative complication rate between the two groups(P>0.05).Conclusion Thoracoscopic segmental lung resection is safer than lobectomy,and the recent efficacy of segmental lung resection is remarkable,with fast postoperative recovery,especially showing good advantage in the postoperative pulmonary function protection.

关 键 词：肺部恶性疾病 胸腔镜 肺叶切除 肺段切除 并发症 

分 类 号：R734.2[医药卫生—肿瘤]