胸腔镜肺叶切除术与肺段切除术治疗早期肺癌的临床分析

目的探讨胸腔镜肺叶切除术与肺段切除术治疗早期肺癌的有效性及安全性。方法选取我院2016年09月至2018年12月收治的早期肺癌患者75例,根据手术方式不同分为肺段切除组(34例)和肺叶切除组(41例)。观察2组患者手术时间、术中出血量、胸留置管时间、胸腔引流量、住院时间、并发症等相关指标以及术后肺功能、生活质量等指标的差异。结果肺段切除组患者术中出血、胸腔引流量、胸管留置时间、抗生素运用时间、住院时间、住院花费均低于肺叶切除组,但手术时间长于肺叶切除组,P<0.05。术后3d肺段切除组患者VAS低于肺叶切除组,P<0.05。肺段切除组术后3个月FVC%、FEV1(%)、MVV(%)高于肺叶组,P<0.05。肺段切除组术后3个月患者生理机能、精力、社会功能、精神健康的评分明显高于肺叶切除组,P<0.05。随访研究中2组患者复发率、1年生存率无统计学差异,P>0.05。结论胸腔镜肺段切除与肺叶切除手术效果及安全性相当,但肺段切除减少肺功能损伤,加快患者术后康复、改善患者生活质量。

Clinical analysis of thoracoscopic lobectomy and segmental pneumonectomy in treatment of early lung cancer

Objective To investigate the efficacy and safety of thoracoscopy lobectomy and segmentectomy for early lung cancer.Methods 75 patients with early lung cancer treated in our hospital from September 2016 to December 2018 were selected and divided into the pulmonary resection group(34 cases)and the lobectomy group(41 cases)according to different surgical methods.The differences in surgical-related indicators and postoperative pulmonary function and quality of life were compared between the two groups.Results The intraoperative bleeding,thoracic drainage,chest tube indwelling time,antibiotic application time,hospitalization time,and hospitalization cost were lower in the pulmonary resection group than in the lobectomy group,but the operation time was longer than that in the lobectomy group(P<0.05).The VAS of the pneumonectomy group was lower than that of the lobectomy group 3 days after surgery(P<0.05).The value of FVC%,FEV1(%),and MVV(%)was higher in the lobectomy group 3 months after operation than in the control group(P<0.05).The scores of physiological function,energy,social function,and mental health of patients in the pulmonary segment resection group 3 months after operation were significantly higher than those in the pulmonary lobe resection group(P<0.05).There was no obvious difference in the recurrence rate and 1-year survival rate between the two groups during follow-up(P>0.05).Conclusion The effect and safety of thoracoscopic lobectomy is the same as lobectomy,but it can reduce the damage of lung function,accelerate the recovery and improve the quality of life.