老年非小细胞肺癌不同肺叶切除手术方式治疗的临床分析
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摘要
目的 :研究不同肺叶切除手术方式对老年非小细胞肺癌患者疗效的影响。方法 :选取2014年5月～2017年7月期间在我院进行治疗的52例非小细胞肺癌患者进行研究,按照随机数表法,随机分为肺叶切除术组和姑息切除术组,每组26例,分别采用标准的肺叶切除术和姑息切除术治疗。比较两组患者的手术相关指标、临床疗效和生存质量。比较两组患者复发、转移情况以及生存率状况。结果 :两组的手术时间、术中出血量、住院时间、淋巴结清扫数目等指标相比,差异无统计学意义。两组的临床疗效相比,差异均无统计学意义。术后6个月,姑息切除术组的生存质量各方面的得分均明显高于肺叶切除术组,差异有统计学意义。术后1年,姑息切除术组的局部复发率低于肺叶切除术组,差异有统计学意义;两组的远处转移率和生存率相比,差异无统计学意义。结论 :标准的肺叶切除术与姑息切除术应用于老年非小细胞肺癌中的治疗效果相当,患者的生存率也接近,但姑息切除术能够提高患者的生存质量,降低术后复发率,对患者的预后具有积极作用。
Objective To study the effect of different lobectomy methods on the curative effect of elderly patients with nonsmall cell lung cancer. Methods 52 cases of non-small cell lung cancer patients from May 2014 to July 2017 in our hospital were randomly divided into study group and palliative lobectomy resection group, respectively, and each group has 26 cases,they were used standard lobectomy and palliative resection. The operative parameters of two groups were compared: operation time, blood loss, length of hospital stay and number of lymph node dissection. The clinical efficacy and the quality of life were compared between the two groups. The prognosis of the two groups was compared. The recurrence, metastasis and survival rate were recorded. Results The operation time, intraoperative blood loss, hospitalization time, number of lymph node of the two groups were compared, the difference was not statistically significant. There was no significant difference in clinical efficacy between the two groups.6 months after surgery, scores of all aspects of life quality were higher than the lobectomy group, the difference was statistically significant.1 years after surgery, palliative resection group the recurrence rate is lower than the lobectomy group, the difference was statistically significant. There was no statistically significant difference in the rate of distant metastasis between the two groups and survival rate. Conclusion Standard pneumonectomy and palliative resection in elderly patients with non-small cell lung cancer in the treatment, the survival rate of the patients is close, but palliative resection can improve the quality of life of patients, reduce the recurrence rate, has a positive effect on the prognosis of the patients.
Objective To study the effect of different lobectomy methods on the curative effect of elderly patients with nonsmall cell lung cancer. Methods 52 cases of non-small cell lung cancer patients from May 2014 to July 2017 in our hospital were randomly divided into study group and palliative lobectomy resection group, respectively, and each group has 26 cases,they were used standard lobectomy and palliative resection. The operative parameters of two groups were compared: operation time, blood loss, length of hospital stay and number of lymph node dissection. The clinical efficacy and the quality of life were compared between the two groups. The prognosis of the two groups was compared. The recurrence, metastasis and survival rate were recorded. Results The operation time, intraoperative blood loss, hospitalization time, number of lymph node of the two groups were compared, the difference was not statistically significant. There was no significant difference in clinical efficacy between the two groups.6 months after surgery, scores of all aspects of life quality were higher than the lobectomy group, the difference was statistically significant.1 years after surgery, palliative resection group the recurrence rate is lower than the lobectomy group, the difference was statistically significant. There was no statistically significant difference in the rate of distant metastasis between the two groups and survival rate. Conclusion Standard pneumonectomy and palliative resection in elderly patients with non-small cell lung cancer in the treatment, the survival rate of the patients is close, but palliative resection can improve the quality of life of patients, reduce the recurrence rate, has a positive effect on the prognosis of the patients.
引文
[1]蒋姗彤,李萍萍.老年晚期非小细胞肺癌姑息治疗获益研究进展[J].中国肺癌杂志, 2015, 18(07):462-468.
[2]李艳,郭其森.晚期非小细胞肺癌维持治疗进展[J].中华肿瘤防治杂志, 2014, 21(10):800-804.
[3]孙少林,刘铁钦,王启文,等.310例65岁以上老年人非小细胞肺癌的手术治疗[J].中国癌症杂志, 2015, 25(05):382-386.
[4]何江,金星,李钟.胸腔镜辅助小切口术在非小细胞肺癌治疗中的应用价值及对患者C反应蛋白的影响[J].湖南师范大学学报(医学版), 2016, 13(06):38-40.
[5]赵纯,曹隆想,张翀,等.胸腔镜下肺段切除术与肺叶切除术治疗肺癌的近期疗效评估[J].华中科技大学学报(医学版), 2015,44(02):213-216, 222.
[6]王述民,童向东,刘博,等.达芬奇机器人左肺上叶切除术和淋巴结清除术治疗非小细胞肺癌[J].中国胸心血管外科临床杂志,2015, 22(03):215-219.
[7]张午临,刘晖,贾涛,等.胸腔镜小切口手术对非小细胞肺癌患者CRP、TNF-α及IL-6等指标水平的影响[J].实用癌症杂志, 2014,29(10):1294-1297.
[8]李文兵,高德伟,卢文宁,等.80岁以上老年非小细胞肺癌切除术后并发症及预后分析[J].解放军医学杂志, 2014, 39(10):823-825.
[9]李胜平,胡卫建,谷电雷.两种手术方式对非小细胞肺癌手术对照研究[J].临床肺科杂志, 2014, 19(09):1663-1667.
[10]顾美华,张洪波,倪蓉,等.呼吸功能训练对胸腔镜下肺叶切除术患者肺功能康复的影响[J].湖南师范大学学报(医学版), 2015,12(04):25-28.
[11]林称意.胸腔镜辅助肺叶切除术对早中期肺癌患者免疫功能及心肺功能的影响[J].实用心脑肺血管病杂志, 2015, 23(12):80-83.
[2]李艳,郭其森.晚期非小细胞肺癌维持治疗进展[J].中华肿瘤防治杂志, 2014, 21(10):800-804.
[3]孙少林,刘铁钦,王启文,等.310例65岁以上老年人非小细胞肺癌的手术治疗[J].中国癌症杂志, 2015, 25(05):382-386.
[4]何江,金星,李钟.胸腔镜辅助小切口术在非小细胞肺癌治疗中的应用价值及对患者C反应蛋白的影响[J].湖南师范大学学报(医学版), 2016, 13(06):38-40.
[5]赵纯,曹隆想,张翀,等.胸腔镜下肺段切除术与肺叶切除术治疗肺癌的近期疗效评估[J].华中科技大学学报(医学版), 2015,44(02):213-216, 222.
[6]王述民,童向东,刘博,等.达芬奇机器人左肺上叶切除术和淋巴结清除术治疗非小细胞肺癌[J].中国胸心血管外科临床杂志,2015, 22(03):215-219.
[7]张午临,刘晖,贾涛,等.胸腔镜小切口手术对非小细胞肺癌患者CRP、TNF-α及IL-6等指标水平的影响[J].实用癌症杂志, 2014,29(10):1294-1297.
[8]李文兵,高德伟,卢文宁,等.80岁以上老年非小细胞肺癌切除术后并发症及预后分析[J].解放军医学杂志, 2014, 39(10):823-825.
[9]李胜平,胡卫建,谷电雷.两种手术方式对非小细胞肺癌手术对照研究[J].临床肺科杂志, 2014, 19(09):1663-1667.
[10]顾美华,张洪波,倪蓉,等.呼吸功能训练对胸腔镜下肺叶切除术患者肺功能康复的影响[J].湖南师范大学学报(医学版), 2015,12(04):25-28.
[11]林称意.胸腔镜辅助肺叶切除术对早中期肺癌患者免疫功能及心肺功能的影响[J].实用心脑肺血管病杂志, 2015, 23(12):80-83.