电视胸腔镜手术在胸部肿瘤治疗中的应用

目的探讨电视胸腔镜手术(VATS)治疗胸部肿瘤的临床效果。方法 52例胸部肿瘤患者分成2组,对照组26例给予传统开胸术治疗,观察组26例给予VATS治疗;观察比较2组患者的围术期情况、实验室指标水平和术后随访情况。结果与对照组比较,观察组患者的手术切口小(P<0.05),术中出血量、术后引流量和术后镇痛药使用量少(P<0.05),住院时间短(P<0.05)。术前2组患者血清C反应蛋白(CRP)、白细胞介素(IL)-6、IL-8和肿瘤坏死因子(TNF)-α水平比较差异均无统计学意义(P>0.05);术后24、72 h,2组患者血清CRP、IL-6、IL-8和TNF-α水平均显著高于术前(P<0.05);2组患者术后72 h血清CRP、IL-6、IL-8和TNF-α水平均显著低于术后24 h(P<0.05);术后24、72 h,观察组患者血清CRP、IL-6、IL-8和TNF-α水平均显著低于对照组(P<0.05)。观察组患者术后并发症发生率和3 a复发率均显著低于对照组(P<0.05),观察组患者3 a存活率显著高于对照组(P<0.05)。结论 VATS治疗胸部肿瘤可减轻手术创伤,缩短住院时间,降低患者术后并发症发生率,提高患者存活率。

Application of video assisted thoracic surgery operation in thoracic tumor

Objective To investigate the clinical effect of video assisted thoracoscopic surgery(VATS) in treatment of thoracic tumor.Methods Fifty-two patients with thoracic tumor were divided into two groups,twenty-six patients in control group were treated with traditional thoracotomy,while the twenty-six patients in observation group were treated with VATS.The peroperative situations,the level of laboratory parameters and postoperative follow-up were observed and compared between the two groups.Results Compared with control group,the size of operative incision was small(P<0.05),the amount of bleeding in operation,the postoperative drainage and the dosage of postoperative analgesics were less(P<0.05),and the hospitalization time was shorter in obervation group(P<0.05).Before operation,there was no significant difference in the levels of serum C-reactive protein(CRP),interleukin-6(IL-6),IL-8 and tumor necrosis factor-α(TNF-α) between the two groups(P<0.05).The levels of serum CRP,IL-6,IL-8 and TNF-α at the time of 24 and 72 hours after operation were significantly higher than those before operation in the two groups(P<0.05).The levels of serum CRP,IL-6,IL-8 and TNF-α at the time of 72 hours after operation were significantly lower than those at the time of 24 hours after operation in the two groups(P<0.05).At the time of 24 and 72 hours after operation,the levels of serum CRP,IL-6,IL-8 and TNF-α in observation group were significantly lower than those in control group(P<0.05).The incidence of postoperative complications and 3-year recurrence rate in observation group were significantly lower than those in control group(P<0.05).The 3-year survival rate in observation group was significantly higher than that in control group(P<0.05).Conclusion VATS for the treatment of thoracic tumor can reduce surgical trauma,shorten hospitalization time,reduce the incidence of postoperative complications,and improve survival rate of patients.