回顾性分析单操作孔与传统多孔VATS肺结节切除术对SPN患者恢复进程及预后情况的影响  

Retrospective Comparative Analysis of the Effect of Single Port and Traditional Multi Port VATS Pulmonary Nodule Resection on the Recovery Process and Prognosis of Patients with Solitary Pulmonary Nodules

作　　者：苏盼龙 苗旺[1] 刘方 韩永强 周硕果[1] 李红秀 冀晓歌 贺兰天 Su Panlong;Miao Wang;Liu Fang(Department of Thoracic Surgery,North Branch of The Third People’s Hospital of Zhengzhou,Zhengzhou,Henan,450000,China)

机构地区：[1]郑州市第三人民医院北部院区胸外科,河南郑州450000

出　　处：《黑龙江医学》2025年第7期790-792,共3页Heilongjiang Medical Journal

摘　　要：目的:回顾性分析单操作孔与传统多孔电视胸腔镜手术(VATS)肺结节切除术治疗孤立性肺结节(SPN)患者的效果及对恢复进程、预后情况的影响。方法:回顾性分析2022年1月—2024年3月郑州市第三人民医院收治的100例SPN患者资料,按手术方案不同分两组。以接受单操作孔VATS肺结节切除术治疗的50例患者列为A组,以接受传统多孔VATS肺结节切除术治疗的50例患者列为B组。对比两组患者手术及术后恢复指标,术前、术后1个月肺功能[一氧化碳弥散量(DLCO)、用力肺活量(FVC)、最大通气量(MVV)],术后1 d、3 d、7 d视觉模拟量表(VAS)评分,术前、术后3 d应激损伤指标[丙二醛(MDA)、P物质(SP)、超氧化物歧化酶(SOD)、C反应蛋白(CRP)]水平,并发症发生率。结果:B组首次下床活动、住院时间均长于A组,B组术中失血量及术后引流量均高于A组,差异均有统计学意义(t=9.051、13.153、10.712、18.479,P<0.001);术后1个月,A组DLCO、FVC、MVV水平高于B组,差异均有统计学意义(t=7.768、6.881、7.500,P<0.001);术后1 d、3 d、7 d,A组VAS评分均低于B组,差异均有统计学意义(t=7.832、8.318、13.373,P<0.001);术后3 d,A组血清MDA、SP、CRP水平较B组低,SOD较B组高,差异均有统计学意义(t=7.285、24.832、5.897、9.123,P<0.001);B组并发症发生率高于A组,差异有统计学意义(χ^(2)=5.005,P<0.05)。结论:相较于多孔VATS肺结节切除术治疗SPN患者,经单操作孔VATS肺结节切除术治疗SPN患者可减少并发症,且对机体产生的应激损伤更轻微,对肺功能影响更小。经单操作孔VATS肺结节切除术治疗更有助于降低术中失血量及术后引流量,缩短恢复进程,减轻术后疼痛感。Objective:To compare the effect of single port and traditional multi port video-assisted thoracoscopic surgery(VATS)for pulmonary nodule resection in the treatment of patients with solitary pulmonary nodules(SPN),and its impact on the recovery process and prognosis.Methods:The data of 100 patients with SPN in the hospital from January 2022 to March 2024 were collected,and they were divided into two groups according to the operation schemes.Among them,50 patients who received single port VATS pulmonary nodule resection were included in group A,and 50 patients who received traditional multi port VATS pulmonary nodule resection were included in group B.The levels of operation and postoperative recovery indicators were compared between the two groups,as well as the levels of lung function[diffusing capacity of the lungs for carbon monoxide(DLCO),forced vital capacity(FVC),maximum ventilation volume(MVV)]before and 1 month after operation,visual analogue scale(VAS)scores at 1 d,3 d,7 d after operation,stress injury indicators[malondialdehyde(MDA),substance P(SP),superoxide dismutase(SOD),C-reactive protein(CRP)]before and 3 d after operation,and the incidence of complications was compared between the two groups.Results:The first time getting out of bed and hospitalization time in group B were longer than those in group A,and the intraoperative blood loss and postoperative drainage volume in group B were lower than those in group A,with statistically significant difference(t=9.051,13.153,10.712,18.479;P<0.05).1 month after surgery,the levels of DLCO,FVC and MVV in group A were higher than those in group B,with statistically significant difference(t=7.768,6.881,7.500;P<0.05).The VAS score of group A was lower than that of group B 1 d 3 d and 7 d after surgery,and the differences were statistically significant(t=7.832,8.318,13.373;P<0.05).3 days after surgery,the levels of MDA,SP and CRP in serum of group A were lower than those of group B,and the levels of SOD were higher than those of group B,with statistically signifi

关 键 词：孤立性肺结节 单操作孔 恢复进程 并发症 应激损伤 电视胸腔镜手术 

分 类 号：R561[医药卫生—呼吸系统]