早期非小细胞肺癌经VATS联合系统性纵隔淋巴结清扫术治疗的回顾性研究  

Retrospective Study of Patients with Early Non-small Cell Lung Cancer Treated with VATS Combined with Systematic Mediastinal Lymph Node Dissection

作　　者：孙凡 任中海[1] 张茹 时祥音 SUN Fan;REN Zhong-hai;ZHANG Ru;SHI Xiang-yin(Thoracic Surgery Department,Nanyang Central Hospital,Nanyang 473000,Henan Province,China)

机构地区：[1]南阳市中心医院胸外科,河南南阳473000

出　　处：《罕少疾病杂志》2025年第2期53-55,共3页Journal of Rare and Uncommon Diseases

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20191450)。

摘　　要：目的探究早期非小细胞肺癌患者经电视胸腔镜(VATS)联合系统性纵隔淋巴结清扫术治疗效果。方法以本院2021年9月至2023年10月期间医治的95例早期非小细胞肺癌患者为研究对象,依据不同手术方式分为A组(n=49)、B组(n=46),前者行单孔VATS肺叶切除术+系统性纵隔淋巴结清扫术,后者行三孔VATS肺叶切除术+系统性纵隔淋巴结清扫术。比较两组手术指标手术前后呼吸功能[动脉血氧分压(PaO_(2))、峰值呼气流速(PEF)、用力肺活量(FVC)]、炎性应激[肿瘤坏死因子-α(TNF-α)、皮质醇(COR)、白细胞介素-1β(IL-1β)]、疼痛程度及并发症状况。结果与B组相比,A组术后引流量、出血量较少,止痛药使用时间、住院时间、下床活动时间均较短(P<0.05);术后2W,两组FVC、PaO_(2)、PEF指标均高于术前(P<0.05);术后3d,与B组相比,A组血清TNF-α、COR、IL-1β水平较低(P<0.05);术后,与B组相比,A组疼痛评分较低(P<0.05);两组并发症发生率相比(2.04%VS 8.69%),差异无统计学意义(P>0.05)。结论单孔VATS肺叶切除术+系统性纵隔淋巴结清扫术能改善患者呼吸功能,减轻炎性应激反应,降低疼痛感,加快患者康复进程。Objective To explore the efficacy of video-assisted thoracoscopy(VATS)combined with systemic mediastinal lymph node dissection in patients with early non-small cell lung cancer.Methods A total of 95 patients with early non-small cell lung cancer treated in our hospital from September 2021 to October 2023 were divided into group A(n=49)and group B(n=46)according to different surgical methods.The former underwent single-port VATS lobectomy+systematic mediastinal lymph node dissection.The latter underwent three-port VATS lobectomy+systematic mediastinal lymph node dissection.The surgical indicators and complications of the two groups were compared,as well as the respiratory function[arterial partial pressure of oxygen(PaO_(2)),peak expiratory flow rate(PEF),forced vital capacity(FVC)],inflammatory stress[tumor necrosis factor-α(TNF-α),cortisol(COR),interleukin-1β(IL-1β)],and pain level before and after surgery.Results Compared with group B,group A had less drainage volume and blood loss,and the time of painkiller use,hospital stay and getting out of bed were shorter(P<0.05).At 2W after operation,the indexes of FVC,PaO_(2) and PEF in both groups were higher than those before operation(P<0.05).After 3 days,the serum levels of TNF-α,COR and IL-1βin group A were lower than those in group B(P<0.05).After operation,NRS score in group A was lower than that in group B(P<0.05).There was no significant difference in the incidence of complications between the two groups(2.04%VS 8.69%)(P>0.05).Conclusion Single-port VATS lobectomy+systematic mediastinal lymph node dissection can improve patients'respiratory function,reduce inflammatory stress response,alleviate pain,and accelerate the recovery process.

关 键 词：早期非小细胞肺癌 电视胸腔镜 纵隔淋巴结清扫术 呼吸功能 炎性应激指标 

分 类 号：R563[医药卫生—呼吸系统]