两种胸腔镜肺癌手术方式对早期非小细胞肺癌患者短期疗效及预后的影响  

Effects of two kinds of thoracoscopic lung cancer surgical methods on short-term efficacy and prognosis of patients with early non-small cell lung cancer

作　　者：王代勇 江章贵 郑乔瑞 WANG Daiyong;JIANG Zhanggui;ZHENG Qiaorui(Department of Thoracic Surgery,Shangrao People's Hospital,Shangrao,Jiangxi,334000,China)

机构地区：[1]上饶市人民医院胸外科,江西上饶334000

出　　处：《当代医学》2024年第36期51-55,共5页Contemporary Medicine

摘　　要：目的探讨两种胸腔镜肺癌手术方式对早期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者短期疗效及预后的影响。方法回顾性分析2020年1月至2021年6月上饶市人民医院收治的102例早期NSCLC患者的临床资料,根据手术方案的不同分为肺段切除术组(n=50)与肺叶切除术组(n=52)。肺段切除术组实施胸腔镜精准肺段切除术,肺叶切除术组实施胸腔镜肺叶切除术。比较两组手术相关指标、手术前后肺功能指标[用力肺活量(forced vital capacity,FVC)、第1秒用力呼气容积占用力肺活量比值(percentage of forced expiratory volume in one second to forced vital capacity,FEV_(1)/FVC)、最大自主通气量(maximal voluntary ventilation,MVV)]与免疫功能指标[CD3^(+)、CD4^(+)/CD8^(+)、自然杀伤(natural killer,NK)细胞百分比]、术后并发症发生情况及复发、转移情况。结果肺段切除术组手术时间长于肺叶切除术组,术中出血量、术后引流量均少于肺叶切除术组,术后住院时间短于肺叶切除术组,差异有统计学意义(P<0.05),两组淋巴结清扫数目比较差异无统计学意义。术后3 d,两组FVC、MVV均小于术前,FEV_(1)/FVC均低于术前,但肺段切除术组FVC、MVV均大于肺叶切除术组,FEV_(1)/FVC高于肺叶切除术组,差异有统计学意义(P<0.05)。术后3 d,两组CD3^(+)、CD4^(+)/CD8^(+)、NK细胞百分比均低于术前,但肺段切除术组高于肺叶切除术组,差异有统计学意义(P<0.05)。两组术后并发症发生率比较差异无统计学意义。术后随访12~24个月,两组均无死亡或复发、转移病例发生。结论早期NSCLC实施胸腔镜下精准肺段切除术与肺叶切除术短期疗效相当,术后生存及复发情况也无明显差异,但精准肺段切除术对患者肺功能、免疫功能的影响更小,术后恢复更快。Objective To investigate the effects of two kinds of thoracoscopic lung cancer surgical methods on short-term efficacy and prognosis of patients with early non-small cell lung cancer(NSCLC).Methods The clinical data of 102 patients with early NSCLC admitted to Shangrao People's Hospital from January 2020 to June 2021 were retrospectively analyzed,and they were divided into the segmentectomy group(n=50)and the lobectomy group(n=52)according to the specific surgical plan.The segmentectomy group underwent thoracoscopic precise segmentectomy,and the lobectomy group underwent thoracoscopic lobectomy.The surgical related indexes and pulmonary function indexes(forced vital capacity[FVC],percentage of forced expiratory volume in one second to forced vital capacity[FEV_(1)/FVC],maximum voluntary ventilation[MVV])and immune function indexes(CD3^(+),CD4^(+)/CD8^(+),percentage of natural killer[NK]cells)before and after surgical,occurrence of postoperative complications and recurrence,metastasis were compared between the two groups.Results The surgical time in the segmentectomy group was longer than that in the lobectomy group,the amount of intraoperative blood loss and postoperative drainage volume were less than those in the lobectomy group,the postoperative hospitalization time was shorter than that in the lobectomy group,and the differences were statistically significant(P<0.05),there was no significant difference in the number of lymph nodes cleared between the two groups.At 3 d after surgery,the FVC and MVV of the two groups were lower than those before surgery,and the FEV_(1)/FVC was lower than that before surgery,but the FVC and MVV in the segmentectomy group were higher than those in the lobectomy group,and the FEV_(1)/FVC was higher than that in the lobectomy group,the differences were statistically significant(P<0.05).At 3 d after surgery,the CD3^(+),CD4^(+)/CD8^(+)and percentages of NK cells of the two groups were lower than before surgery,but the segmentectomy group was higher than the lobectomy group,and the di

关 键 词：早期非小细胞肺癌 胸腔镜 肺叶切除术 精准肺段切除术 免疫功能 短期疗效 预后 

分 类 号：R73[医药卫生—肿瘤]