胸腔镜肺叶切除术与传统开胸肺叶切除术治疗老年肺癌患者的效果比较  

Comparison of effect of thoracoscopic lobectomy and traditional thoracotomy lobectomy in treatment of elderly patients with lung cancer

作　　者：王坤亮 闫进 袁俊华 WANG Kunliang;YAN Jin;YUAN Junhua(Guangji Cardiovascular Hospital,Department of Thoracic Surgery Zhumadian 463000 Henan,China;Guangji Cardiovascular Hospital,Department of Radiology Zhumadian 463000 Henan,China;Department of Cardiothoracic Surgery of 990 Hospital of Joint Logistics Support Force,Zhumadian 463000 Henan)

机构地区：[1]驻马店广济心血管病医院胸外科,河南驻马店463000 [2]驻马店广济心血管病医院医院放射科,河南驻马店463000 [3]联勤保障部队990医院心胸外科,河南驻马店463000

出　　处：《中国民康医学》2025年第9期145-147,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:比较胸腔镜肺叶切除术与传统开胸肺叶切除术治疗老年肺癌患者的效果。方法:回顾性分析2020年1月至2021年6月驻马店广济心血管病医院收治的75例老年肺癌患者的临床资料,按治疗方案不同将其分为观察组35例、对照组40例。对照组采用传统开胸肺叶切除术治疗,观察组采用胸腔镜肺叶切除术治疗,比较两组术后不同时间视觉模拟评分法(VAS)评分、应激指标[皮质醇、P物质、去甲肾上腺素(NE)]水平、并发症发生率和生存率。结果:术后12、24、48 h,观察组VAS评分低于对照组,差异均有统计学意义(P<0.05);术后6 h,两组血清皮质醇、P物质、NE等应激指标水平高于术前,但观察组低于对照组,差异均有统计学意义(P<0.05);观察组并发症发生率为5.71%,低于对照组的22.50%,差异有统计学意义(P<0.05);术后1年,观察组生存率为88.57%(31/35),明显高于对照组的65.00%(26/40),差异有统计学意义(P<0.05);术后2年,观察组生存率为80.00%(28/35),明显高于对照组的57.50%(23/40),差异有统计学意义(P<0.05)。结论:胸腔镜肺叶切除术治疗老年肺癌患者可提高术后1、2年生存率,以及降低术后VAS评分、应激指标水平和并发症发生率,效果优于传统开胸肺叶切除术治疗。Objective:To compare effects of thoracoscopic lobectomy and traditional thoracotomy lobectomy in treatment of elderly patients with lung cancer.Methods:The clinical data of 75 elderly patients with lung cancer admitted to Guangji Cardiovascular Hospital from January 2020 to June 2021 were retrospectively analyzed.According to different treatment options,they were divided into observation group(35 cases)and control group(40 cases).The control group was treated with traditional thoracotomy lobectomy,while the observation group was treated with thoracoscopic lobectomy.The visual analogue scale(VAS)scores and the stress indexes[cortisol,substance P,norepinephrine(NE)]levels at different time points,the incidence of complications,and the survival rate were compared between the two groups.Results:At 12,24 and 48 h after the surgery,the VAS score of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).At 6 h after the surgery,the levels of serum cortisol,substance P,NE and other stress indexes in the two groups were higher than those before the surgery,but those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was 5.71%,which was lower than 22.50%in the control group,and the difference was statistically significant(P<0.05).One year after the surgery,the survival rate of the observation group was 88.57%(31/35),which was significantly higher than 65.00%(26/40)of the control group,and the difference was statistically significant(P<0.05).Two years after the surgery,the survival rate of the observation group was 80.00%(28/35),which was significantly higher than 57.50%(23/40)of the control group,and the difference was statistically significant(P<0.05).Conclusions:Thoracoscopic lobectomy for the elderly patients with lung cancer can improve the survival rates of 1 and 2 years after the surgery,and reduce the postoperative VAS sco

关 键 词：胸腔镜 开胸 肺叶切除术 老年 肺癌 疼痛 应激 

分 类 号：R734.2[医药卫生—肿瘤]