单孔胸腔镜在老年患者肺结节切除中的应用  

Single⁃port Thoracoscopy in the Resection of Pulmonary Nodules in Elderly Patients

作　　者：陆如建[1] 卢帅 LU Rujian;LU Shuai(Department of Thoracic Surgery,Nantong Third People's Hospital,Nantong University,Nantong,Jiangsu 226000,China)

机构地区：[1]南通市第三人民医院·南通大学附属南通第三医院胸外科,江苏南通226000

出　　处：《转化医学杂志》2024年第8期1251-1255,共5页Translational Medicine Journal

基　　金：江苏省老年健康科研项目(LKM2023041)。

摘　　要：目的评估单孔与三孔胸腔镜技术在老年肺结节手术中的疗效,分析单孔胸腔镜手术对肺功能恢复速度、术后康复进程以及并发症发生风险的临床效应。方法选取2020年6月至2023年12月接受治疗的180例老年肺结节患者,随机分配至2组,每组90例。对照组采取传统三孔胸腔镜手术,观察组采用单孔胸腔镜手术,2组均采用肺段切除术治疗。主要评估指标包括手术持续时间、术中出血量、术后拔管时间、术后引流液量、住院时间、术后疼痛评分,比较术前及术后1周肺功能指标[第一秒用力呼气容积(FEV1)、用力肺活量(FVC)、每分钟最大通气量(MVV)及FEV1/FVC],同时记录并发症发生情况。结果2组手术持续时间比较差异并不显著(P>0.05)。观察组术后拔管时间及住院时间均较对照组更长(P<0.05)。观察组术中出血量、术后引流量较对照组更少,并且术后第1、3天疼痛评分也明显低于对照组(P<0.05)。术后1周,观察组FEV1、FVC、MVV均高于对照组,FEV1/FVC也较对照组更为理想(P<0.05)。2组并发症总发生率比较差异无统计学意义(P>0.05)。结论单孔胸腔镜手术在老年肺结节治疗中展现出积极的临床效益,有助于降低手术侵袭性,加速肺功能恢复,且不增加并发症的风险。Objective To evaluate the efficacy of single⁃orifice thoracoscopy and three⁃orifice thoracoscopy in elderly patients with pulmonary nodules,and analyze the clinical effects of single⁃orifice thoracoscopy on the speed of pulmonary func⁃tion recovery,postoperative rehabilitation process and the risk of complications.Methods A total of 180 elderly patients with pulmonary nodules who received treatment from June 2020 to December 2023 were randomly assigned to 2 groups with 90 pa⁃tients in each group.Traditional three⁃hole thoracoscopic surgery was performed in the control group,single⁃hole thoracoscopic surgery was performed in the observation group,and segmental resection was performed in both groups.The main evaluation indicators included operation duration,intraoperative blood loss,postoperative extubation time,postoperative drainage vol⁃ume,hospital stay,postoperative pain score,and preoperative and postoperative pulmonary function indicators[forced expira⁃tory volume in the first second(FEV1),forced vital capacity(FVC),maximum volume per minute(MVV)and FEV1/FVC]were compared.Complications were also recorded.Results There was no significant difference in operation duration between the two groups(P>0.05).The duration of extubation and hospitalization in the observation group was longer than that in the control group(P<0.05).The intraoperative blood loss and postoperative drainage volume in the observation group were less than those in the control group,and the pain scores on the 1st and 3rd day after surgery were significantly lower than those in the control group(P<0.05).One week after operation,FEV1,FVC and MVV in the observation group were higher than those in the control group,and FEV1/FVC was more ideal than that in the control group(P<0.05).There was no sig⁃nificant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Single⁃port thora⁃coscopic surgery has shown positive clinical benefits in the treatment of elderly pulmonary nodules,helping to

关 键 词：单孔胸腔镜技术 肺结节 肺功能 术后并发症 疼痛 

分 类 号：R655.3[医药卫生—外科学]