CVAT和TOS治疗老年早期非小细胞肺癌对患者免疫炎性反应、心肺功能及预后的影响
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摘要
目的探讨CVAT和TOS治疗老年早期非小细胞肺癌对患者免疫炎性反应、心肺功能及预后的影响。方法随机选择原发性非小细胞肺癌老年患者90例,根据术式的不同分为研究组和对照组,其中研究组(行全胸腔镜肺叶切除术) 45例,对照组(行开胸肺叶切除术) 45例。比较2组患者围术期指标等差异。结果 2组患者在手术时间、术中出血量、引流管置管时间、引流管引流量、术后并发症发生率及住院时间方面比较,均有统计学差异(P <0. 05);而2组患者在淋巴结清扫情况方面比较有统计学差异(P>0. 05)。术前2组患者的血清免疫炎性反应相关指标水平比较均无统计学差异(P>0. 05);而术后1周2组血清免疫指标Ig G、Ig A及Ig M水平均有所下降,但对照组水平明显低于研究组;而2组血清炎性指标C-反应蛋白及白介素-6水平均有所升高且对照组水平明显高于研究组,比较均有统计学差异(P <0. 05)。术前2组患者的预后相关指标水平比较均无统计学差异(P> 0. 05),而术后3天2组预后相关指标均有所升高且对照组高于研究组(P <0. 05),但在术后1周,2组预后相关指标均下降且组间比较无明显差异(P> 0. 05);术前2组患者的心肺功能相关指标水平比较均无统计学差异(P>0. 05),而术后1周2组心肺功能相关指标比较均有统计学差异(P <0. 05)。术后1年,2组患者的生存率比较无明显差异(P>0. 05)。结论在早期老年NSCLC治疗中采用全胸腔镜肺叶切除术进行治疗的预后情况与开放手术一致,但对患者免疫应激反应及心肺功能影响较小,值得推广。
Objective To investigate the immune inflammatory response、cardio-pulmonary function and prognosis between CVAT and TOS in old patients with early NSCLC. Methods A retrospective analysis of 90 cases of old patients with early NSCLC were to the curative effect of different treatments,45 cases of experimental group gives the complete videoassisted thoracoscopic surgery,the control group given traditional open surgery,and analysis and comparison of two groups with perioperative indexes and so on. Results There had statistical difference between the 2 groups in operation time,intraoperative amountof bleeding and so on( P < 0. 05),but there was no significant difference in the number of lymph node dissection between the 2 groups( P >0. 05). There had statistical difference between the 2 groups in immune inflammatory response and cardio-pulmonary function( P< 0. 05). There was no significant difference in prognosis between the 2 groups( P > 0. 05). Conclusion The CVAT had better clinical effect than TOS with the same prognosis for old patients with early NSCLC.
Objective To investigate the immune inflammatory response、cardio-pulmonary function and prognosis between CVAT and TOS in old patients with early NSCLC. Methods A retrospective analysis of 90 cases of old patients with early NSCLC were to the curative effect of different treatments,45 cases of experimental group gives the complete videoassisted thoracoscopic surgery,the control group given traditional open surgery,and analysis and comparison of two groups with perioperative indexes and so on. Results There had statistical difference between the 2 groups in operation time,intraoperative amountof bleeding and so on( P < 0. 05),but there was no significant difference in the number of lymph node dissection between the 2 groups( P >0. 05). There had statistical difference between the 2 groups in immune inflammatory response and cardio-pulmonary function( P< 0. 05). There was no significant difference in prognosis between the 2 groups( P > 0. 05). Conclusion The CVAT had better clinical effect than TOS with the same prognosis for old patients with early NSCLC.
引文
[1]袁源,谭群友,王如文,等.单操作孔胸腔镜与辅助小切口肺叶切除治疗早期Nsc Lc的疗效分析〔J〕.重庆医学,2014,43(12):1431-1433.
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[8]张明,吴奇勇,王勇,等.单孔全胸腔镜下肺叶切除术治疗早期肺癌〔J〕.中国微创外科杂志,2016,16(12):1125-1126,1130.
[9]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(2):213-216,222.
[10]隋锡朝,杨帆,李运,等. 1131例单中心全胸腔镜肺叶切除治疗非小细胞肺癌的远期疗效〔J〕.中华胸心血管外科杂志,2015,31(8):472-476,480.
[11]徐凯英,王思桦,王建军.早期非小细胞肺癌电视辅助胸腔镜手术淋巴结清扫进展〔J〕.临床外科杂志,2017,25(7):556-558.
[12] Kim HK,Han KN. Uniportal video-assisted thoracoscopic surgery-segmentectomy〔J〕. Thorac Surg Clin,2017,27(4):387-398.
[13]罗东,尹杰,柯有力.电视胸腔镜肺叶切除术治疗早期非小细胞肺癌临床分析〔J〕.微创医学,2015,10(1):22-24.
[2]膳洪生,张志伟,杨洋.胸腔镜肺叶切除治疗非小细胞肺癌的近远期疗效及影响因素分析〔J〕.重庆医学,2014,43(14):1764-1767.
[3]殷勇,张小康.全胸腔镜肺叶切除术与传统开胸手术治疗早期非小细胞肺癌的疗效分析〔J〕.实用癌症杂志,2016,31(7):1137-1139.
[4]赵云鹏,丛波,赵小刚,等.全胸腔镜肺叶切除与开胸肺叶切除淋巴结清扫及生存的meta分析〔J〕.中华胸心血管外科杂志,2014,30(8):470-471.
[5]豆亚伟,吕珊珊,田伟,等.全胸腔镜肺叶切除治疗Ⅰ/Ⅱ期非小细胞肺癌的临床效果〔J〕.中国胸心血管外科临床杂志,2017,24(3):192-195.
[6]牟巨伟,张百华,李宁,等.电视辅助胸外科手术与常规开胸手术治疗非小细胞肺癌的近期效果比较〔J〕.中华肿瘤杂志,2012,34(4):301-305.
[7]艾成,陈有东,李勇,等.全胸腔镜肺叶切除术治疗早期非小细胞肺癌患者的预后分析〔J〕.现代生物医学进展,2016,16(31):6165-6168.
[8]张明,吴奇勇,王勇,等.单孔全胸腔镜下肺叶切除术治疗早期肺癌〔J〕.中国微创外科杂志,2016,16(12):1125-1126,1130.
[9]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(2):213-216,222.
[10]隋锡朝,杨帆,李运,等. 1131例单中心全胸腔镜肺叶切除治疗非小细胞肺癌的远期疗效〔J〕.中华胸心血管外科杂志,2015,31(8):472-476,480.
[11]徐凯英,王思桦,王建军.早期非小细胞肺癌电视辅助胸腔镜手术淋巴结清扫进展〔J〕.临床外科杂志,2017,25(7):556-558.
[12] Kim HK,Han KN. Uniportal video-assisted thoracoscopic surgery-segmentectomy〔J〕. Thorac Surg Clin,2017,27(4):387-398.
[13]罗东,尹杰,柯有力.电视胸腔镜肺叶切除术治疗早期非小细胞肺癌临床分析〔J〕.微创医学,2015,10(1):22-24.