全胸腔镜手术对非小细胞肺癌患者围术期指标及应激反应的影响  

Effects of total thoracoscopic surgery on perioperative indexes and stress response in patients with non-small cell lung cancer

作　　者：程领 薄霞 张玉珠 Cheng Ling;Bo Xia;Zhang Yuzhu(Department of Thoracic SurgeryⅡ,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院胸外二科,郑州450000

出　　处：《中国实用医刊》2024年第22期5-8,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析全胸腔镜手术对非小细胞肺癌(NSCLC)患者围术期指标及应激反应的影响。方法队列研究。抽取2021年8月至2023年8月郑州大学第一附属医院收治的NSCLC患者64例,按照随机数字表法分为对照组和观察组,每组32例。对照组接受胸腔镜辅助小切口手术治疗,观察组接受全胸腔镜手术治疗,随访至出院。比较两组围术期指标;比较两组术前及术后即刻炎性因子[白细胞介素-12(IL-12)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]、应激反应[去甲肾上腺素(NE)、皮质醇(Cor)、促肾上腺皮质激素(ACTH)]水平;比较两组治疗期间并发症发生情况。结果观察组术中出血量、术后引流量少于对照组,住院时间短于对照组(P<0.05)。术后即刻,两组血清IL-12、CRP、TNF-α及NE、Cor、ACTH水平均高于术前,但观察组IL-12、CRP、TNF-α及NE、Cor、ACTH水平均低于对照组(P均<0.05)。两组住院期间并发症发生率比较差异未见统计学意义(P>0.05)。结论全胸腔镜手术治疗NSCLC可改善围术期指标,控制炎性因子和应激反应,且安全性良好。ObjectiveTo analyze the effects of total thoracoscopic surgery on perioperative indexes and stress response in patients with non-small cell lung cancer(NSCLC).MethodsSixty-four patients with NSCLC admitted to the First Affiliated Hospital of Zhengzhou University from August 2021 to August 2023 were selected for the cohort study.And they were divided into the control group and the observation group by random number table method,with 32 cases in each group.The control group received small-incision thoracoscopic surgery,and the observation group received total thoracoscopic surgery;both groups were followed up until discharge.The perioperative indexes of the two groups were compared;the levels of inflammatory factors,including interleukin-12(IL-12),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),and stress responses assessed by norepinephrine(NE),cortisol(Cor),adrenocorticotropic hormone(ACTH)before and immediately after surgery were compared between two groups;the incidence of complications during treatment of the two groups were compared.ResultsThe intraoperative bleeding and postoperative drainage volume of the observation group were less than those of the control group,and the hospital stay was shorter than that of the control group(P<0.05).Immediately after surgery,the levels of serum IL-12,CRP,TNF-α,NE,Cor,and ACTH in both groups were higher than preoperative levels,but the levels of IL-12,CRP,TNF-α,NE,Cor,and ACTH in the observation group were lower than those in the control group(all P<0.05).There was no significant difference in the incidence of complications during hospitalization between the two groups(P>0.05).ConclusionsTotal thoracoscopic surgery for NSCLC can improve perioperative indexes,and control inflammatory factors and stress response,with good safety.

关 键 词：非小细胞肺癌 全胸腔镜手术 应激反应 炎性因子 安全性 

分 类 号：R734.2[医药卫生—肿瘤]