固有段切除术与肺叶切除术对患者肺功能的影响  

Effect of intrinsic segmental resection versus lobectomy on pulmonary function in patients

作　　者：黎增亮 马国栋[1,2] LI Zengliang;MA Guodong(Department of Thoracic Surgery,Nanjing Chest Hospital,Nanjing,Jiangsu 210029,China;Department of Thoracic Surgery,Affiliated Nanjing Brain Hospital,Nanjing Medical University,Nanjing,Jiangsu 210029,China)

机构地区：[1]南京市胸科医院胸外科,江苏南京210029 [2]南京医科大学附属脑科医院胸外科,江苏南京210029

出　　处：《临床肺科杂志》2025年第3期325-329,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的比较左上肺固有段切除术与左上肺叶切除术对患者肺功能的影响。方法分析南京市胸科医院胸外科2021年3月-2023年3月行胸腔镜下左上肺固有段切除术和左上肺叶切除术患者的临床资料,根据性别、年龄、吸烟史、饮酒史、体重指数等因素进行倾向性评分匹配,其中左上肺固有段切除术组和左上肺叶切除术组各48例入组。比较两组的基本临床特征,术后临床指标及术后1个月、3个月、6个月的FVC、FEV_(1)/FVC以及肺容积的减小比率等指标。结果左上肺固有段切除术组的手术时间为(137.4±32.8)min,左上肺叶切除术组为(140.5±30.4)min,差异无统计学意义;术中出血量两组分别为(84.3±41.1)mL和(90.5±37.0)mL,差异无统计学意义;术后胸管放置时间两组分别为(5.6±2.4)d和(6.3±2.3)d,差异无统计学意义;术后住院时间两组分别为(6.2±2.1)d和(7.1±2.2)d,差异有统计学意义。两组患者术后6个月的FVC分别为(2205±124)mL和(2158±128)mL;FEV_(1)/FVC分别为(77.3±4.6)%和(75.6±4.4)%;左肺容积减少分别为(23.9±4.1)%和(25.3±3.3)%;全肺容积减少分别为(15.5±3.9)%和(16.8±4.1)%;上述指标差异均无统计学意义。结论左上肺固有段切除术相比于左上肺叶切除术,并不能明显保留患者术后的肺功能。Objective Comparison of the effects of resection of the intrinsic segment of the left upper lung versus left upper lobectomy on patients′lung function.Methods The clinical data of patients who underwent thoracoscopic left upper lung intrinsic segmentectomy and left upper lobectomy in the Department of Thoracic Surgery of Nanjing Chest Hospital from March 2021 to March 2023 were analyzed and the patients were matched with propensity scores according to gender,age,smoking history,drinking history,body mass index,etc.,of which 48 cases were enrolled in each of the left upper lung intrinsic segmentectomy group and left upper lobectomy group.The basic clinical characteristics,postoperative clinical indexes,and the indexes of FVC,FEV_(1)/FVC,and the reduction ratio of lung volume at 1 month,3 months,and 6 months after surgery were compared between the two groups.Results The operation time was(137.4±32.8)min in the left upper lung intrinsic segment resection group and(140.5±30.4)min in the left upper lobectomy group,with no statistically significant difference;intraoperative bleeding was(84.3±41.1)mL and(90.5±37.0)mL in the two groups,respectively,with no statistically significant difference;postoperative chest tube placement time was(5.6±2.4)d and(6.3±2.3)d in the two groups,respectively,with no statistically significant difference;and postoperative chest tube placement time was(5.6±2.4)d and(6.3±2.3)d in the two groups,respectively,with no statistically significant difference;postoperative hospitalization time was(6.2±2.1)d and(7.1±2.2)d in the two groups,respectively,with a statistically significant difference.The FVC of the two groups at 6 months postoperatively were(2205±124)mL and(2158±128)mL respectively;the FEV_(1)/FVC were(77.3±4.6)%and(75.6±4.4)%,respectively;the volume reduction of the left lung was(23.9±4.1)%and(25.3±3.3)%,respectively;and the volume reduction of the whole lung was(15.5±3.9)%and(16.8±4.1)%,respectively;the differences in the above indexes were not statistically significan

关 键 词：固有段切除术 左上肺叶切除术 肺功能 

分 类 号：R73[医药卫生—肿瘤]