达芬奇机器人系统与电视辅助胸腔镜手术治疗≤2cm早期肺癌术后炎症及免疫指标变化的比较研究  

A comparative study of the changes of inflammatory and immune parameters in Leonardo’s robot and video-assisted thoracoscopic surgery for early-stage lung cancer ≤2 cm in diameter

作　　者：马常天 Ma Changtian(Department of Thoracic Surgery,Provincial Hospital Affiliated to Shandong First Medical University,Jinan Shandong 250000,China;Department of Thoracic Surgery,Heze Hospital of Traditional Chinese Medicine Affiliated to Shandong University of)

机构地区：[1]山东第一医科大学附属省立医院胸外科,山东济南250000 [2]山东中医药大学附属菏泽市中医医院胸外科,山东菏泽274000

出　　处：《中国医刊》2025年第1期43-47,共5页Chinese Journal of Medicine

摘　　要：目的比较达芬奇机器人系统与电视辅助胸腔镜手术治疗≤2 cm早期肺癌术后炎症及免疫指标的变化,探讨达芬奇机器人系统在早期肺癌手术治疗中的应用价值。方法回顾性分析2023年9-12月在山东第一医科大学附属省立医院胸外科行根治手术治疗的111例≤2cm早期肺癌患者的临床资料,其中行达芬奇机器人系统辅助胸腔镜手术46例(A组),行电视辅助胸腔镜手术65例(B组)。比较两组的手术时间、术中失血量、淋巴结清扫数目、胸腔引流时间、术后72 h引流量、术后住院时间等手术相关指标,围手术期血清C反应蛋白(CRP)、降钙素原(PCT)、白介素(IL)-6、IL-8、IL-10、肿瘤坏死因子-α(TNF-α)等炎症指标,外周血CD4^(+)T细胞、CD8^(+)T细胞、NK细胞、B淋巴细胞百分比,CD4^(+)/CD8^(+)T细胞比值和血清IgG、IgA、IgM水平等免疫指标,以及术后并发症发生情况。结果所有患者均顺利完成根治手术。A组手术时间、胸腔引流时间和术后住院时间短于B组,术中失血量、术后72 h引流量低于B组,淋巴结清扫数目多于B组,差异均有统计学意义(P<0.05)。术前两组血清CRP、PCT、IL-6、IL-8、IL-10、TNF-α水平比较差异无统计学意义(P>0.05);术后两组上述炎症指标均明显高于术前,且B组明显高于A组,差异有统计学意义(P<0.05)。术前及术后两组各免疫指标组间比较差异均无统计学意义(P>0.05)。A组术后并发症发生率(8.70%)与B组(9.23%)比较差异无统计学意义(P>0.05)。结论与电视辅助胸腔镜手术相比,达芬奇机器人系统辅助胸腔镜手术治疗≤2 cm早期肺癌在技术和短期疗效上具有一定优势,有助于减轻术后炎症反应,但在免疫功能方面未表现出明显优势。Objective To compare the changes of inflammatory and immune parameters between Leonardo’s robot system and video-assisted thoracoscopic surgery in the treatment of early-stage lung cancer≤2 cm in diameter,and evaluate the superiority of Leonardo’s robot system.Method The clinical data of 111 patients with early-stage lung cancer≤2 cm in diameter,who underwent radical surgery from September 2023 to December 2023 in Department of Thoracic Surgery of The provincial hospital affiliated to Shandong First Medical University,were analyzed retrospectively.46 patients underwent Leonardo’s robot assisted thoracoscopic surgery(Group A)and 65 patients underwent video assisted thoracoscopic surgery(Group B).The surgical-related indicators such as operation time,intraoperative blood loss,number of lymph nodes dissected,duration of thoracic drainage,drainage within 72 hours postoperatively,and postoperative hospital stay;perioperative serum inflammatory indicators such as C-reactive protein(CRP),procalcin(PCT),interleukin(IL)-6,IL-8,IL-10,and tumor necrosis factor-α(TNFα);immune indicators such as the percentage of peripheral blood CD4^(+)T cells,CD8^(+)T cells,NK cells,B lymphocytes,the ratio CD4^(+)/CD8^(+)T cells,and serum levels of IgG,IgA,and IgM;and the occurrence of postoperative complications were compared between the two groups.Result All the patients underwent radical surgery successfully.The operation time,chest drainage time,and postoperative hospital stay were shorter in group A than in group B,and the intraoperative blood and postoperative 72-hour drainage volume were less than those in group B,and the number of lymph nodes dissected was more than that in group B all with statistically significant differences(P<0.05).There were no significant differences in the preoperative serum levels of CRP,PCT,IL6,IL-8,IL-10,and TNF-αbetween the two groups(P>0.05);the above inflammatory indicators significantly higher postoperatively in both groups;group B was significantly higher than group A,with statist

关 键 词：达芬奇机器人系统 电视辅助胸腔镜手术 早期肺癌 炎症反应 免疫功能 

分 类 号：R734.2[医药卫生—肿瘤]