对比VATS与OT肺癌根治术对非小细胞肺癌患者术后免疫抑制及预后的影响
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摘要
目的对比VATS与OT肺癌根治术对患者术后免疫抑制及预后的影响。方法随机选取2015年8月至2018年8月江苏省徐州市丰县人民医院非小细胞肺癌患者60例,按先后序列号(1～60)随机分为采用全胸腔镜肺癌根治术的VATS组和采用传统开胸肺癌根治术组的OT组,每组30例,统计分析两组患者的临床疗效、术中术后指标、免疫抑制能力。结果 VATS组患者治疗的总有效率(93%,28/30)显著高于OT组(83%,25/30),差异有统计学意义(P <0.05),手术时间、拔管时间、住院时间均显著短于OT组(P <0.05),术中出血量、术后胸液引流量均显著少于OT组(P <0.05),术后血清IL-6、TNF-α、CRP、VEGF水平均显著低于OT组(P <0.05)。结论 VATS较OT肺癌根治术更能有效提升患者术后免疫抑制能力,改善患者预后。
Objective To compare the effects of VATS and OT lung cancer radical surgery on postoperative immune suppression and prognosis of patients with non-small cell lung cancer. Methods Sixty patients with non-small cell lung cancer in our hospital from August 2015 to August 2018 were randomly selected and randomly divided into two groups according to the serial number(1-60): a group of total thoracoscopic radical lung cancer surgery group(VATS group,30 cases)and a group of traditional open lung cancer radical surgery group(OT group, 30 cases). The clinical efficacy,intraoperative and postoperative indexes,and immunosuppressive ability of the two groups were compared. Results The total effective rate of treatment in the VATS group was 93%(28/30), which was significantly higher than that in the OT group(83%, 25/30)(P<0.05). The operation time, extubation time, and hospitalization time were significantly shorter than the OT group(P<0.05), intraoperative blood loss and postoperative pleural fluid drainage were significantly less than OT group(P<0.05), postoperative serum IL-6, TNF-α, CRP and VEGF levels were significantly lower than OT group(P<0.05). Conclusion VATS is more effective than OT lung cancer radical surgery in improving postoperative immunosuppressive ability and prognosis of patients.
Objective To compare the effects of VATS and OT lung cancer radical surgery on postoperative immune suppression and prognosis of patients with non-small cell lung cancer. Methods Sixty patients with non-small cell lung cancer in our hospital from August 2015 to August 2018 were randomly selected and randomly divided into two groups according to the serial number(1-60): a group of total thoracoscopic radical lung cancer surgery group(VATS group,30 cases)and a group of traditional open lung cancer radical surgery group(OT group, 30 cases). The clinical efficacy,intraoperative and postoperative indexes,and immunosuppressive ability of the two groups were compared. Results The total effective rate of treatment in the VATS group was 93%(28/30), which was significantly higher than that in the OT group(83%, 25/30)(P<0.05). The operation time, extubation time, and hospitalization time were significantly shorter than the OT group(P<0.05), intraoperative blood loss and postoperative pleural fluid drainage were significantly less than OT group(P<0.05), postoperative serum IL-6, TNF-α, CRP and VEGF levels were significantly lower than OT group(P<0.05). Conclusion VATS is more effective than OT lung cancer radical surgery in improving postoperative immunosuppressive ability and prognosis of patients.
引文
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[13]王园,王科峰.快速康复外科理念在胸腔镜肺癌根治术围手术期的应用[J].上海护理,2017,17(5):45-47.
[14]Huang W,Liu J,Liang W,et al.Outcome and safety of radical resection in non-small cell lung cancer patients via glasses-Free 3-dimensional video-assisted thoracoscope versus 2-dimensional video-assisted thoracoscope[J].Surg Innov,2018,25(2):121-127.
[15]Tan J,Song Z,Bian Q,et al.Effects of volume-controlled ventilation vs.pressure-controlled ventilation on respiratory function and inflammatory factors in patients undergoing video-assisted thoracoscopic radical resection of pulmonary carcinoma[J].J Thorac Dis,2018,10(3):1483-1489.
[2]刘先岭,智明明,王静静,等.胸椎旁神经阻滞复合全身麻醉对胸腔镜肺癌根治术患者镇痛及免疫细胞功能的影响[J].中国现代医学杂志,2017,27(22):47-51.
[3]张振龙,潘小杰,郭天兴,等.单操作孔全胸腔镜肺癌根治术124例[J].中国微创外科杂志,2017,17(9):844-846.
[4]吴树彪,蔡莉娜,董铁立,等.胸椎旁神经阻滞与全身麻醉对胸腔镜肺癌根治术患者术后镇痛效果及血清相关肿瘤标志物水平的影响[J].中国老年学杂志,2018,38(3):611-614.
[5]罗洞波,高云飞,吴振华,等.单孔与三孔胸腔镜肺癌根治术对患者免疫功能的影响对比[J].临床和实验医学杂志,2017,16(8):771-774.
[6]陈柯宇,颜美琼.促进术后恢复综合方案在胸腔镜肺癌根治术围手术期护理的应用[J].中国实用护理杂志,2018,34(24):1866-1869.
[7]黄菲燕,杨利英,孙惠华,等.优质护理在单孔胸腔镜肺癌根治术患者中的应用[J].齐鲁护理杂志,2018,24(2):85-87.
[8]孔岚,卢锡华.右美托咪啶对胸腔镜肺癌根治术患者围手术期炎症反应及细胞免疫功能的影响[J].中华医学杂志,2018,98(36):2929-2932.
[9]朱国勇,姜杰,于修义,等.不同年度3D与2D胸腔镜肺癌根治术的对比研究[J].中国医师杂志,2017,19(12):1807-1809.
[10]杨静,夏氢,何伟,等.胸椎旁神经阻滞对胸腔镜肺癌根治术后疼痛程度、应激反应、免疫应答的影响[J].海南医学院学报,2018,24(3):357-360.
[11]张伟,孙铭阳,李冰,等.麻醉因素对胸腔镜肺癌根治术患者肺损伤的影响:右美托咪定混合罗哌卡因胸椎旁神经阻滞联合全麻的效果[J].中华麻醉学杂志,2018,38(1):34-39.
[12]孟杰,肖航,曾宪伟,等.超声引导下前锯肌平面阻滞对胸腔镜肺癌根治术术后镇痛及炎性反应的影响[J].临床肺科杂志,2018,23(5):913-916.
[13]王园,王科峰.快速康复外科理念在胸腔镜肺癌根治术围手术期的应用[J].上海护理,2017,17(5):45-47.
[14]Huang W,Liu J,Liang W,et al.Outcome and safety of radical resection in non-small cell lung cancer patients via glasses-Free 3-dimensional video-assisted thoracoscope versus 2-dimensional video-assisted thoracoscope[J].Surg Innov,2018,25(2):121-127.
[15]Tan J,Song Z,Bian Q,et al.Effects of volume-controlled ventilation vs.pressure-controlled ventilation on respiratory function and inflammatory factors in patients undergoing video-assisted thoracoscopic radical resection of pulmonary carcinoma[J].J Thorac Dis,2018,10(3):1483-1489.