术前新辅助化疗联合外科手术治疗非小细胞肺癌的临床效果
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摘要
目的探究术前新辅助化疗联合外科手术治疗非小细胞肺癌的临床效果及生活质量改善效果。方法选取60例非小细胞肺癌患者作为研究对象,以随机数字表法将其分为观察组与对照组,对照组患者(30例)实施外科手术治疗,观察组患者(30例)术前辅助化疗联合外科手术治疗。对比2组患者治疗后疗效、手术情况、手术切除率及并发症率、治疗前后患者生存质量(SF-36)评分,随访1年,观察2组患者肿瘤复发率及生存率。结果观察组患者治疗有效率(70. 00%)高于对照组(43. 33%),P <0. 05。2组患者均成功完成手术,患者手术时间、术中失血量、术后24 h胸腔引流量、术后胸管留置时间均相当(P> 0. 05)。观察组患者手术切除率(100. 00%)显著高于对照组(83. 33%),P <0. 05;并发症率为13. 33%,与对照组相当(20. 00%),P> 0. 05。治疗前2组患者生存质量评分相当(P> 0. 05),治疗后2组患者SF-36量表评分改善,观察组优于对照组(P <0. 05)。观察组患者1年肿瘤复发率为3. 33%,低于对照组23. 33%(P<0. 05);生存率为96. 67%,高于对照组80. 00%(P <0. 05)。结论术前辅助化疗联合外科手术治疗非小细胞肺癌可提升临床疗效及手术切除率,改善患者生活质量,且患者1年肿瘤复发率低、生存率高,值得推广应用。
Objective To explore the survival and quality of life of patients with non-small cell lung cancer with preoperative adjuvant chemotherapy combined with surgery. Methods 60 patients with non-small cell lung cancer were treated as the research object,by the method of random Numbers table will be divided into the observation group and control group,the control group( 30 cases) received surgical treatment,the observation group( 30 cases) received preoperative adjuvant chemotherapy in combination with surgical treatment,compared two groups of patients with curative effect,operation situation,the resection rate and complication rate,before and after treatment,patients quality of life( SF-36) score,followed up for 1 year,observe the 2 groups of patients with tumor recurrence rate and survival rate. Results The effective rate of treatment in the observation group( 70. 00%)was higher than that of the control group( 43. 33%),P < 0. 05; The patients in both groups successfully completed the operation,and the time of operation,intraoperative blood loss,24 h thoracic drainage,and postoperative chest tube retention time were all equal,p BBB 0. The surgical removal rate( 100. 00%) was significantly higher in the observation group than the control group( 83. 33%),P < 0. 05,and the complication rate was 13. 33%,compared with the control group( 20. 00%),and P > 0. 05. The survival quality scores were similar in the 2 groups before treatment,and the score of sf-36 in each group was improved after treatment,and the observation group was better than the control group,P < 0. 05. In the observation group,the recurrence rate of the tumor was 3. 33% in 1 year,23. 33% in the control group,96. 67% in the control group,80. 00% in the control group,P < 0. 05,and the difference was statistically significant. Conclusion Preoperative adjuvant chemotherapy in combination with surgical treatment of non-small cell lung cancer can improve clinical curative effect and surgical resection,patients quality of life improved significantly,and tumor recurrence rate is low,1 year survival rate is high,it is worthy of popularization and application.
Objective To explore the survival and quality of life of patients with non-small cell lung cancer with preoperative adjuvant chemotherapy combined with surgery. Methods 60 patients with non-small cell lung cancer were treated as the research object,by the method of random Numbers table will be divided into the observation group and control group,the control group( 30 cases) received surgical treatment,the observation group( 30 cases) received preoperative adjuvant chemotherapy in combination with surgical treatment,compared two groups of patients with curative effect,operation situation,the resection rate and complication rate,before and after treatment,patients quality of life( SF-36) score,followed up for 1 year,observe the 2 groups of patients with tumor recurrence rate and survival rate. Results The effective rate of treatment in the observation group( 70. 00%)was higher than that of the control group( 43. 33%),P < 0. 05; The patients in both groups successfully completed the operation,and the time of operation,intraoperative blood loss,24 h thoracic drainage,and postoperative chest tube retention time were all equal,p BBB 0. The surgical removal rate( 100. 00%) was significantly higher in the observation group than the control group( 83. 33%),P < 0. 05,and the complication rate was 13. 33%,compared with the control group( 20. 00%),and P > 0. 05. The survival quality scores were similar in the 2 groups before treatment,and the score of sf-36 in each group was improved after treatment,and the observation group was better than the control group,P < 0. 05. In the observation group,the recurrence rate of the tumor was 3. 33% in 1 year,23. 33% in the control group,96. 67% in the control group,80. 00% in the control group,P < 0. 05,and the difference was statistically significant. Conclusion Preoperative adjuvant chemotherapy in combination with surgical treatment of non-small cell lung cancer can improve clinical curative effect and surgical resection,patients quality of life improved significantly,and tumor recurrence rate is low,1 year survival rate is high,it is worthy of popularization and application.
引文
[1]陆磊,周秋云,钱智磊,等.2014-2015年南京市胸科医院肺癌化疗辅助用药的使用情况分析[J].现代药物与临床,2016,31(1):101-105.
[2]郑礼胜,崔艳丽,金玉洁,等.非小细胞肺癌EGFR-T790M突变药物的研究进展[J].现代药物与临床,2017,32(7):1381-1387.
[3]谭祥.血清肿瘤标志物CEA、CA724、CA242、CA19-9联合检测诊断肺癌的临床价值分析[J].标记免疫分析与临床,2017,24(8):900-904.
[4]左江华,李宗良,任宏涛,等.血清CEA、CA125、CA199联合检测在肺癌诊断中的应用价值[J].标记免疫分析与临床,2016,23(6):668-671.
[5]张梦阳,贺慧,刘秋雨,等.207例肺癌纤维支气管镜细胞病理学方法的诊断价值探讨[J].海军医学杂志,2015,11(4):347-350.
[6]彭苗,苏琼菲,莫凯岚,等.术后辅助放疗对ⅢA-N2期非小细胞肺癌的疗效探讨[J].实用癌症杂志,2017,32(3):484-488.
[7]杨世兵,胡杰伟,周海宁.胸腔镜手术与传统开胸手术对非小细胞肺癌患者心肺功能的影响及疗效分析[J].实用癌症杂志,2017,32(6):969-971+974.
[8]王南,黄泽清.全身麻醉下肺癌根治术中反比通气与常规通气模式对患者肺泡炎症因子及免疫功能影响[J].临床军医杂志,2017,45(10):1064-1067.
[9]菅青,孔欣,纪静,等.替莫唑胺联合伽马刀在肺癌脑转移治疗中应用[J].创伤与急危重病医学,2017,5(1):28-31.
[10]杜丽,唐育民.曲马多联合罗哌卡因行肋间神经阻滞用于肺癌患者术后镇痛的临床研究[J].东南大学学报(医学版),2015,8(2):235-239.
[11]任军龙,薛磊,孙光远,等.胸腔镜下肺癌根治术治疗早期非小细胞肺癌临床观察[J].山东医药,2015,11(23):48-50.
[12]王静,李丽,韩辉,等.肺功能锻炼对阻塞性通气功能障碍肺癌患者肺功能及手术耐受性的影响[J].中华物理医学与康复杂志,2017,39(3):202-206.
[13]傅志强,周琪,何文新,等.老年肺癌与中年肺癌手术患者的临床资料对比分析[J].中国癌症杂志,2015,6(8):624-628.
[14]王兴,阎石,王亚旗,等.基于临床路径进行的肺癌外科质量监测与持续改进:单一手术组经验总结[J].中国肺癌杂志,2017,20(4):253-258.
[15]陈纯烨.手术治疗非小细胞肺癌患者预后的影响因素[J].中国老年学杂志,2015,7(5):1409-1410.
[16]王亚龙,王亚格,胡箫,等.153例经外科干预的非小细胞肺癌伴胸膜播散患者的预后研究[J].中国肿瘤临床,2017,44(14):712-716.
[17]李万刚,崔静,王建军,等.术前支气管动脉灌注化疗治疗Ⅲa(N2)期非小细胞肺癌[J].介入放射学杂志,2015,24(2):160-165.
[18]张海容.术前复方苦参注射液联合化疗对肺癌患者恶性程度的影响[J].药学实践杂志,2016,34(4):359-362.
[19]王继云,李婷,邹伟,等.非气管插管胸腔镜下肺癌手术的临床应用[J].中国内镜杂志,2017,23(8):7-12.
[20]王兵,律方,赵亮,等.完全电视胸腔镜手术与胸腔镜辅助小切口手术治疗早期非小细胞肺癌临床疗效的Meta分析[J].中国肺癌杂志,2017,20(5):303-311.
[21]周文武,周亚夫,张志功,等.术前新辅助化疗对ⅢA期非小细胞肺癌的近-中期疗效分析[J].临床医药文献电子杂志,2017,65(4):12739-12741.
[22]夏礼,蒋米娜,吴智宁,等.新辅助化疗在ⅢA期非小细胞肺癌术前应用临床分析[J].中国医师杂志,2017,19(12):1844-1846.
[2]郑礼胜,崔艳丽,金玉洁,等.非小细胞肺癌EGFR-T790M突变药物的研究进展[J].现代药物与临床,2017,32(7):1381-1387.
[3]谭祥.血清肿瘤标志物CEA、CA724、CA242、CA19-9联合检测诊断肺癌的临床价值分析[J].标记免疫分析与临床,2017,24(8):900-904.
[4]左江华,李宗良,任宏涛,等.血清CEA、CA125、CA199联合检测在肺癌诊断中的应用价值[J].标记免疫分析与临床,2016,23(6):668-671.
[5]张梦阳,贺慧,刘秋雨,等.207例肺癌纤维支气管镜细胞病理学方法的诊断价值探讨[J].海军医学杂志,2015,11(4):347-350.
[6]彭苗,苏琼菲,莫凯岚,等.术后辅助放疗对ⅢA-N2期非小细胞肺癌的疗效探讨[J].实用癌症杂志,2017,32(3):484-488.
[7]杨世兵,胡杰伟,周海宁.胸腔镜手术与传统开胸手术对非小细胞肺癌患者心肺功能的影响及疗效分析[J].实用癌症杂志,2017,32(6):969-971+974.
[8]王南,黄泽清.全身麻醉下肺癌根治术中反比通气与常规通气模式对患者肺泡炎症因子及免疫功能影响[J].临床军医杂志,2017,45(10):1064-1067.
[9]菅青,孔欣,纪静,等.替莫唑胺联合伽马刀在肺癌脑转移治疗中应用[J].创伤与急危重病医学,2017,5(1):28-31.
[10]杜丽,唐育民.曲马多联合罗哌卡因行肋间神经阻滞用于肺癌患者术后镇痛的临床研究[J].东南大学学报(医学版),2015,8(2):235-239.
[11]任军龙,薛磊,孙光远,等.胸腔镜下肺癌根治术治疗早期非小细胞肺癌临床观察[J].山东医药,2015,11(23):48-50.
[12]王静,李丽,韩辉,等.肺功能锻炼对阻塞性通气功能障碍肺癌患者肺功能及手术耐受性的影响[J].中华物理医学与康复杂志,2017,39(3):202-206.
[13]傅志强,周琪,何文新,等.老年肺癌与中年肺癌手术患者的临床资料对比分析[J].中国癌症杂志,2015,6(8):624-628.
[14]王兴,阎石,王亚旗,等.基于临床路径进行的肺癌外科质量监测与持续改进:单一手术组经验总结[J].中国肺癌杂志,2017,20(4):253-258.
[15]陈纯烨.手术治疗非小细胞肺癌患者预后的影响因素[J].中国老年学杂志,2015,7(5):1409-1410.
[16]王亚龙,王亚格,胡箫,等.153例经外科干预的非小细胞肺癌伴胸膜播散患者的预后研究[J].中国肿瘤临床,2017,44(14):712-716.
[17]李万刚,崔静,王建军,等.术前支气管动脉灌注化疗治疗Ⅲa(N2)期非小细胞肺癌[J].介入放射学杂志,2015,24(2):160-165.
[18]张海容.术前复方苦参注射液联合化疗对肺癌患者恶性程度的影响[J].药学实践杂志,2016,34(4):359-362.
[19]王继云,李婷,邹伟,等.非气管插管胸腔镜下肺癌手术的临床应用[J].中国内镜杂志,2017,23(8):7-12.
[20]王兵,律方,赵亮,等.完全电视胸腔镜手术与胸腔镜辅助小切口手术治疗早期非小细胞肺癌临床疗效的Meta分析[J].中国肺癌杂志,2017,20(5):303-311.
[21]周文武,周亚夫,张志功,等.术前新辅助化疗对ⅢA期非小细胞肺癌的近-中期疗效分析[J].临床医药文献电子杂志,2017,65(4):12739-12741.
[22]夏礼,蒋米娜,吴智宁,等.新辅助化疗在ⅢA期非小细胞肺癌术前应用临床分析[J].中国医师杂志,2017,19(12):1844-1846.