胸腔镜切除术治疗肺多发结节患者的临床疗效分析
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摘要
目的:分析胸腔镜切除术治疗肺多发结节患者的临床疗效。方法:回顾性分析2015年2月-2017年8月本院收治的80例肺多发结节患者的临床资料,根据治疗方式不同分为对照组(开胸手术)和研究组(胸腔镜切除术),各40例。比较两组疗效、并发症、住院时间、引流时间、术后引流量、术中使用钉仓数量、术中出血量等。结果:研究组治疗总有效率为92.50%,高于对照组的75.00%(P<0.05);研究组并发症发生率10.00%,低于对照组的27.50%(P<0.05);研究组住院时间、引流时间、术后引流量、术中出血量均低于对照组,术中使用钉仓数多于对照组,比较差异均有统计学意义(P<0.05)。结论:建议临床治疗肺多发结节采用胸腔镜切除术,与开胸手术比较,其效果更为突出,且创伤小,术后恢复速度快,属于一种有效且安全的诊治方式。
Objective:To analyze the effect of thoracoscopic resection in treatment of patients with multiple pulmonary nodules.Method:The clinical data of 80 patients with multiple pulmonary nodules admitted to our hospital from February 2015 to August 2017 were analyzed retrospectively.According to different treatment methods,they were divided into control group(thoracotomy) and study group(thoracoscopic excision),40 cases in each group.The curative effect,complications,hospitalization time,drainage time,postoperative drainage volume,the number of intraoperative use of nail bunkers,intraoperative bleeding volume between two groups were compared.Result:The total clinical effect in study group was 92.50%,which was higher than 75.00% in control group(P<0.05).The total incidence of complications in study group was 10.00%,which was lower than 27.50% in control group(P<0.05).The curative effect,complications,hospitalization time,drainage time,postoperative drainage volume,intraoperative bleeding volume in study group were lower than those of control group,the number of intraoperative use of nail bunkers was higher than that of control group,the differences were statistically significant(P<0.05).Conclusion:It is recommended to treat multiple pulmonary nodules by thoracoscopic resection,compared with thoracotomy,the effect is more prominent,with less trauma and faster postoperative recovery,it is an effective and safe way of diagnosis and treatment.
Objective:To analyze the effect of thoracoscopic resection in treatment of patients with multiple pulmonary nodules.Method:The clinical data of 80 patients with multiple pulmonary nodules admitted to our hospital from February 2015 to August 2017 were analyzed retrospectively.According to different treatment methods,they were divided into control group(thoracotomy) and study group(thoracoscopic excision),40 cases in each group.The curative effect,complications,hospitalization time,drainage time,postoperative drainage volume,the number of intraoperative use of nail bunkers,intraoperative bleeding volume between two groups were compared.Result:The total clinical effect in study group was 92.50%,which was higher than 75.00% in control group(P<0.05).The total incidence of complications in study group was 10.00%,which was lower than 27.50% in control group(P<0.05).The curative effect,complications,hospitalization time,drainage time,postoperative drainage volume,intraoperative bleeding volume in study group were lower than those of control group,the number of intraoperative use of nail bunkers was higher than that of control group,the differences were statistically significant(P<0.05).Conclusion:It is recommended to treat multiple pulmonary nodules by thoracoscopic resection,compared with thoracotomy,the effect is more prominent,with less trauma and faster postoperative recovery,it is an effective and safe way of diagnosis and treatment.
引文
[1]唐洪均,梅宏,许川,等.完全胸腔镜下解剖性肺段切除术治疗肺小结节病灶临床观察[J].海南医学,2017,28(3):411-413.
[2]陈浩,刘伟,王宏宇,等.CT引导下穿刺注射亚甲蓝定位在胸腔镜治疗肺部小结节中的应用分析[J].现代生物医学进展,2016,16(34):6721-6723.
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[4]钟斌,吴奇勇,童继春,等.胸腔镜肺段或肺叶切除术治疗肺磨玻璃结节的比较研究[J].中国微创外科杂志,2017,17(1):62-64.
[5]陈巍,李文涛,杨泽山,等.单操作孔胸腔镜手术在肺部结节病变患者中的应用价值探讨[J].浙江医学,2016,38(15):1277-1279.
[6]刘本刚,张建伟,王继云,等.全胸腔镜辅助下行解剖性肺段切除术治疗肺部小结节疗效观察[J].陕西医学杂志,2017,46(2):178-179.
[7]王通,马少华,闫天生,等.胸腔镜治疗≤10 mm非小细胞肺癌的临床研究[J].中国肺癌杂志,2016,19(4):216-219.
[8]周逸鸣,张雷,宋楠,等.电视胸腔镜肺切除术治疗肺结核815例分析[J].中国防痨杂志,2017,39(5):448-451.
[9]仲艳,许晓泉,陈亮,等.CT引导下Hookwire与亚甲蓝联合定位对胸腔镜下肺内多发结节切除术的指导价值[J].医学影像学杂志,2017,27(4):667-669.
[10]赖海银,陈梦君,马骏.胸腔镜对周围肺结节诊断和恶性肺结节手术切除的价值[J].实用癌症杂志,2016,31(12):1983-1986.
[11]曾小飞,马瑞东,尚观胜,等.电视胸腔镜术在老年小结节非小细胞肺癌患者治疗中的应用研究[J].现代生物医学进展,2016,16(5):894-897.
[12]倪慧霞,赵卫,胡继红,等.CT引导下微弹簧圈定位在肺小结节胸腔镜术中的临床应用[J].介入放射学杂志,2017,26(6):555-559.
[13]庞文广,黄凤柳,叶敏,等.全腔镜解剖性肺段切除术对比肺叶切除术在治疗早期肺癌的前瞻性研究[J].临床肺科杂志,2017,22(10):1874-1878.
[14]柴振达,陈志军,竺王玉,等.原发性周围型微小肺癌临床特征及预后分析[J].浙江医学,2017,39(5):332-335.
[15]邵丰,杨如松,刘政呈,等.电视胸腔镜手术切除肺部亚厘米非小细胞肺癌的临床病理特征[J].临床与病理杂志,2017,37(1):86-90.
[16]李冬,沈琦斌,郑屹峰,等.肺部小结节胸腔镜术前CT引导下钩线穿刺定位的临床应用[J].浙江医学,2017,39(13):1113-1115.
[17]何晓峰,曹彬,陈宝俊,等.术前CT下弹簧圈定位肺结节在胸腔镜下肺结节切除术中应用的随机对照试验[J].中国胸心血管外科临床杂志,2017,24(11):858-862.
[18]徐春华,于力克,王伟,等.电视胸腔镜术前超声引导下超细支气管镜联合亚甲蓝定位肺小结节的临床应用[J].肿瘤学杂志,2017,23(8):725-727.
[19]张旭刚,杨磊,魏博,等.CT引导下Hookwire定位孤立性肺结节的临床应用及并发症分析[J].临床肺科杂志,2017,22(4):589-592.
[20]黄小燕,郑屹峰,潘锋,等.单一肺结节与两枚以上肺结节胸腔镜切除术前CT引导下hook-wire定位的应用价值[J].肿瘤学杂志,2017,23(10):914-917.
[2]陈浩,刘伟,王宏宇,等.CT引导下穿刺注射亚甲蓝定位在胸腔镜治疗肺部小结节中的应用分析[J].现代生物医学进展,2016,16(34):6721-6723.
[3]王通,闫天生,万峰,等.胸腔镜治疗肺部微小结节(129例报告)[J].中国肺癌杂志,2017,20(1):35-40.
[4]钟斌,吴奇勇,童继春,等.胸腔镜肺段或肺叶切除术治疗肺磨玻璃结节的比较研究[J].中国微创外科杂志,2017,17(1):62-64.
[5]陈巍,李文涛,杨泽山,等.单操作孔胸腔镜手术在肺部结节病变患者中的应用价值探讨[J].浙江医学,2016,38(15):1277-1279.
[6]刘本刚,张建伟,王继云,等.全胸腔镜辅助下行解剖性肺段切除术治疗肺部小结节疗效观察[J].陕西医学杂志,2017,46(2):178-179.
[7]王通,马少华,闫天生,等.胸腔镜治疗≤10 mm非小细胞肺癌的临床研究[J].中国肺癌杂志,2016,19(4):216-219.
[8]周逸鸣,张雷,宋楠,等.电视胸腔镜肺切除术治疗肺结核815例分析[J].中国防痨杂志,2017,39(5):448-451.
[9]仲艳,许晓泉,陈亮,等.CT引导下Hookwire与亚甲蓝联合定位对胸腔镜下肺内多发结节切除术的指导价值[J].医学影像学杂志,2017,27(4):667-669.
[10]赖海银,陈梦君,马骏.胸腔镜对周围肺结节诊断和恶性肺结节手术切除的价值[J].实用癌症杂志,2016,31(12):1983-1986.
[11]曾小飞,马瑞东,尚观胜,等.电视胸腔镜术在老年小结节非小细胞肺癌患者治疗中的应用研究[J].现代生物医学进展,2016,16(5):894-897.
[12]倪慧霞,赵卫,胡继红,等.CT引导下微弹簧圈定位在肺小结节胸腔镜术中的临床应用[J].介入放射学杂志,2017,26(6):555-559.
[13]庞文广,黄凤柳,叶敏,等.全腔镜解剖性肺段切除术对比肺叶切除术在治疗早期肺癌的前瞻性研究[J].临床肺科杂志,2017,22(10):1874-1878.
[14]柴振达,陈志军,竺王玉,等.原发性周围型微小肺癌临床特征及预后分析[J].浙江医学,2017,39(5):332-335.
[15]邵丰,杨如松,刘政呈,等.电视胸腔镜手术切除肺部亚厘米非小细胞肺癌的临床病理特征[J].临床与病理杂志,2017,37(1):86-90.
[16]李冬,沈琦斌,郑屹峰,等.肺部小结节胸腔镜术前CT引导下钩线穿刺定位的临床应用[J].浙江医学,2017,39(13):1113-1115.
[17]何晓峰,曹彬,陈宝俊,等.术前CT下弹簧圈定位肺结节在胸腔镜下肺结节切除术中应用的随机对照试验[J].中国胸心血管外科临床杂志,2017,24(11):858-862.
[18]徐春华,于力克,王伟,等.电视胸腔镜术前超声引导下超细支气管镜联合亚甲蓝定位肺小结节的临床应用[J].肿瘤学杂志,2017,23(8):725-727.
[19]张旭刚,杨磊,魏博,等.CT引导下Hookwire定位孤立性肺结节的临床应用及并发症分析[J].临床肺科杂志,2017,22(4):589-592.
[20]黄小燕,郑屹峰,潘锋,等.单一肺结节与两枚以上肺结节胸腔镜切除术前CT引导下hook-wire定位的应用价值[J].肿瘤学杂志,2017,23(10):914-917.