胸腔镜下肺段切除术与肺楔形切除术治疗早期肺癌的效果比较  

Comparison of therapeutic effect of thoracoscopic segmentectomy and wedge resection of lung on early stage lung cancer

作　　者：张浩亮[1] 王旭[1] 孙继伟 Zhang Haoliang;Wang Xu;Sun Jiwei(Department of Thoracic Surgery,Henan Provincial Chest Hospital,Zhengzhou 450008,China)

机构地区：[1]河南省胸科医院胸外科,郑州450008

出　　处：《中国实用医刊》2025年第2期5-8,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较胸腔镜下肺段切除术与肺楔形切除术治疗早期肺癌的效果。方法队列研究。抽取2019年10月至2022年10月河南省胸科医院收治的早期肺癌患者90例,按照随机数字表法分为对照组和研究组,每组45例。对照组采取胸腔镜下肺段切除术治疗,研究组采取胸腔镜肺楔形切除术治疗。比较两组围术期情况、肺功能[最大呼气流量(PEF)、用力肺活量(FVC)、第1秒用力呼气量(FEV1)]、疼痛数字评分量表(NRS)评分、炎症因子[白细胞计数(WBC)、中性粒细胞计数(NEUT)]水平、并发症及复发率。结果研究组引流量少于对照组,引流时间、住院时间均短于对照组(P均<0.05)。术后3个月,研究组FEV1、FVC高于对照组(P<0.05)。术后24、72 h,研究组NRS评分低于对照组(P<0.05)。术后3个月,研究组NEUT、WBC水平均低于对照组(P均<0.05)。两组并发症发生率比较差异未见统计学意义(P>0.05);研究组复发率(13.33%,6/45)高于对照组(0),差异有统计学意义(P<0.05)。结论与肺段切除术比较,胸腔镜下肺楔形切除术治疗早期肺癌,可减轻疼痛和炎症应激反应,改善肺功能,加快患者术后恢复,但术后有一定复发风险。Objective To analyze the application effect of thoracoscopic segmentectomy and wedge resection of lung in the treatment of early stage lung cancer.Methods Ninety patients with early stage lung cancer treated in Henan Provincial Chest Hospital from October 2019 to October 2022 were selected for the cohort study.And they were divided into the control group and the study group using a random number table method,with 45 cases in each group.The control group was treated by thoracoscopic segmentectomy,and the study group was treated by thoracoscopic wedge resection of lung.The perioperative condition,lung function evaluated by peak expiratory flow(PEF),forced vital capacity(FVC)and forced expiratory volume in 1 second(FEV1),numerical rating scale(NRS)score,levels of inflammatory factors including white blood cell count(WBC)and neutrophil count(NEUT),incidence of complications and recurrence rate were compared between the two groups.ResultsThe study group had less drainage,shorter drainage time and shorter hospital stay than the control group(all P<0.05).Compared with the control group,the study group had higher levels of FEV1 and FVC 3 months after surgery(P<0.05).Compared with the control group,the study group had lower NRS scores at 24 and 72 hours postoperatively(P<0.05).The study group had lower levels of NEUT and WBC than the control group 3 months postoperatively(all P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05),and the recurrence rate of the study group(13.33%,6/45)was higher that of the control group(0),P<0.05.Conclusions Compared with segmentectomy,thoracoscopic wedge resection of lung for early stage lung cancer patients can reduce pain and inflammatory stress response,improve lung function and accelerate patients’postoperative recovery,however,there is a certain risk of recurrence after surgery.

关 键 词：胸腔镜手术 肺楔形切除术 肺段切除术 肺癌 

分 类 号：R73[医药卫生—肿瘤]