胸腔镜下肺段切除术和肺叶切除术治疗肺癌效果对比
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摘要
目的分析肺癌患者采用胸腔镜下肺段切除术与胸腔镜下肺叶切除术治疗的临床疗效。方法选取2015年9月‐2017年9月该院收治的肺癌患者80例,根据手术方式不同随机分为两组,对照组行胸腔镜下肺叶切除术,观察组行胸腔镜下肺段切除术,对比两组患者治疗前后肺功能变化情况、术后疼痛及相关手术指标情况。结果两组术前肺活量占预计值百分比(FVC%)、第一秒用力呼气容积占预计值百分比(FEV1%)对比差异无统计学意义(P>0.05),术后FVC%、FEV1%均有所降低,与术前比较,差异有统计学意义(P <0.05),观察组术后降低幅度小于对照组,差异有统计学意义(P <0.05);两组视觉模拟疼痛评分(VAS)评分比较,观察组术后第1、3、7天评分均低于同期对照组,差异有统计学意义(P <0.05);两组手术时间、术中出血量、住院时间和术后胸管留置时间比较,差异均无统计学意义(P>0.05),观察组胸腔引流量明显少于对照组,差异有统计学意义(P <0.05)。结论肺癌患者采用胸腔镜下肺段切除术与胸腔镜下肺叶切除术均能获得良好治疗效果,但胸腔镜下肺段切除术肺功能损伤较小,值得临床推广。
【Objective】To analyze the clinical efficacy of thoracoscopic lobectomy and thoracoscopic lobectomy for lung cancer patients.【Methods】Eighty patients with lung cancer treated in our hospital from September 2015 to September 2017 were chosen, according to different operation methods they were randomly divided into two groups: control group underwent the thoracoscopic lobe resection, observation group underwent the thoracoscopic lung segment resection, and pulmonary function changes, postoperative pain, relevant operation index of patients in the two groups were compared before and after treatment.【Results】There was no statistically significant difference between the two groups in preoperative FVC% and FEV1%(P >0.05),the postoperative FVC% and FEV1% were both decreased, and compared with the preoperative values, the difference was statistically significant(P <0.05). When compared the VAS scores of the two groups, the postoperative 1 d, 3 d and 7 d scores of the observation group were lower than those of the control group at the same time, and the difference was statistically significant(P <0.05). There was no statistically significant difference between the two groups in postoperative time, intraoperative blood loss, hospitalization time and postoperative thoracic duct indwelling time(P >0.05). The thoracic drainage rate of the observation group was significantly lower than that of the control group, and the difference was statistically significant(P <0.05).【Conclusion】Thoracoscopic pulmonary segmentectomy and thoracoscopic pulmonary lobectomy can achieve good therapeutic effects in lung cancer patients, but thoracoscopic pulmonary lobectomy can cause minor damage to lung function which is worthy to be popularized.
【Objective】To analyze the clinical efficacy of thoracoscopic lobectomy and thoracoscopic lobectomy for lung cancer patients.【Methods】Eighty patients with lung cancer treated in our hospital from September 2015 to September 2017 were chosen, according to different operation methods they were randomly divided into two groups: control group underwent the thoracoscopic lobe resection, observation group underwent the thoracoscopic lung segment resection, and pulmonary function changes, postoperative pain, relevant operation index of patients in the two groups were compared before and after treatment.【Results】There was no statistically significant difference between the two groups in preoperative FVC% and FEV1%(P >0.05),the postoperative FVC% and FEV1% were both decreased, and compared with the preoperative values, the difference was statistically significant(P <0.05). When compared the VAS scores of the two groups, the postoperative 1 d, 3 d and 7 d scores of the observation group were lower than those of the control group at the same time, and the difference was statistically significant(P <0.05). There was no statistically significant difference between the two groups in postoperative time, intraoperative blood loss, hospitalization time and postoperative thoracic duct indwelling time(P >0.05). The thoracic drainage rate of the observation group was significantly lower than that of the control group, and the difference was statistically significant(P <0.05).【Conclusion】Thoracoscopic pulmonary segmentectomy and thoracoscopic pulmonary lobectomy can achieve good therapeutic effects in lung cancer patients, but thoracoscopic pulmonary lobectomy can cause minor damage to lung function which is worthy to be popularized.
引文
[1]龙志华,黄健文.完全胸腔镜下肺叶与肺段切除术治疗I期肺癌的临床对比研究[J].白求恩医学杂志,2016,14(3):301-302.
[2]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.
[3]诸葛雪朋,刘于威,孟庆江,等.胸腔镜解剖性肺段切除术用于治疗老年早期肺癌患者的研究[J].中国实用医刊,2015,42(3):13-14.
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[9]康晓艳,吴艳,常海霞.压力管理对改善胸腔镜肺段切除术治疗早期非小细胞肺癌患者生活质量的效果分析[J].中国医药导报,2017,14(17):170-173.
[10]朱勇刚,赵晓东,周成伟,等.全胸腔镜下肺段切除与肺叶切除治疗I期非小细胞肺癌效果比较[J].中国乡村医药,2016,23(2):21-22.
[11]张艳娇,高禹舜.肺癌胸腔镜肺叶切除、胸腔镜肺段切除与开胸肺叶切除术后对肺功能影响的研究[J].中国肺癌杂志,2016,19(10):700-704.
[12]王庆,张永恒,刘勇恩,等.胸腔镜下肺段切除术治疗非小细胞肺癌的应用现状[J].现代肿瘤医学,2017,25(22):3726-3728.
[13]张小川,仲宁,张亚年,等.胸腔镜下肺段切除与肺叶切除治疗早期肺癌临床疗效评估[J].徐州医科大学学报,2017,37(12):802-804.
[14]Russo JK,Grass D,Armeson KE,et al.Treatment with IntensityModulated Radiation Therapy(IMRT)and chemotherapy in advanced inoperable non-small cell lung cancer(NSCLC):toxicity,survival and patterns of failure in relation to treatment with high and low radiation dose[J].J Cancer Ther,2015,6(11):943-953.
[15]Chen W,Zheng R,Baade PD,et al.Cancer statistics in China,2015[J].CA Cancer J Clin,2016,66(2):115-132.
[2]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.
[3]诸葛雪朋,刘于威,孟庆江,等.胸腔镜解剖性肺段切除术用于治疗老年早期肺癌患者的研究[J].中国实用医刊,2015,42(3):13-14.
[4]蒋浩,马永峰,曹新超,等.直径小于2 cm肺癌胸腔镜肺叶切除术与肺段切除术临床比较分析[J].中国临床医生杂志,2016,44(4):64-66.
[5]张裘,黄国喜.胸腔镜下肺段切除术与肺叶切除术对肺癌患者肺功能的影响[J].局解手术学杂志,2016,25(12):887-888.
[6]郑鑫林,夏学阳,张金周,等.胸腔镜下肺段切除与肺叶切除治疗临床I期非小细胞肺癌疗效对比的Meta分析[J].中国癌症杂志,2016,26(10):854-860.
[7]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.
[8]林宇星.单孔全胸腔镜下解剖性肺段切除术与肺叶切除术治疗早期非小细胞肺癌的临床疗效对比:一项回顾性观察研究[D].福建医科大学,2016.
[9]康晓艳,吴艳,常海霞.压力管理对改善胸腔镜肺段切除术治疗早期非小细胞肺癌患者生活质量的效果分析[J].中国医药导报,2017,14(17):170-173.
[10]朱勇刚,赵晓东,周成伟,等.全胸腔镜下肺段切除与肺叶切除治疗I期非小细胞肺癌效果比较[J].中国乡村医药,2016,23(2):21-22.
[11]张艳娇,高禹舜.肺癌胸腔镜肺叶切除、胸腔镜肺段切除与开胸肺叶切除术后对肺功能影响的研究[J].中国肺癌杂志,2016,19(10):700-704.
[12]王庆,张永恒,刘勇恩,等.胸腔镜下肺段切除术治疗非小细胞肺癌的应用现状[J].现代肿瘤医学,2017,25(22):3726-3728.
[13]张小川,仲宁,张亚年,等.胸腔镜下肺段切除与肺叶切除治疗早期肺癌临床疗效评估[J].徐州医科大学学报,2017,37(12):802-804.
[14]Russo JK,Grass D,Armeson KE,et al.Treatment with IntensityModulated Radiation Therapy(IMRT)and chemotherapy in advanced inoperable non-small cell lung cancer(NSCLC):toxicity,survival and patterns of failure in relation to treatment with high and low radiation dose[J].J Cancer Ther,2015,6(11):943-953.
[15]Chen W,Zheng R,Baade PD,et al.Cancer statistics in China,2015[J].CA Cancer J Clin,2016,66(2):115-132.