电视辅助胸腔镜下解剖性肺切除治疗I期肺癌的临床效果

目的 探讨电视辅助胸腔镜下解剖性肺切除治疗Ⅰ期肺癌的临床效果。方法 采用回顾性研究方法,选取2015年5月至2017年1月广西医科大学附属肿瘤医院收治的I期肺癌患者84例,按照手术方法不同将患者分为两组:观察组和对照组,每组各42例。观察组患者实施电视辅助胸腔镜下解剖性肺切除术治疗,对照组患者给予传统开胸肺叶切除术治疗。比较两组患者的住院时间、切口长度、术中出血量、手术时间、1年和3年生存情况及生活质量评分(SF-36生活量表)变化。结果 观察组患者的住院时间短于对照组(6. 13±1. 46 vs. 10. 39±2. 41 d),切口长度小于对照组(4. 38±1. 09 vs. 11. 84±3. 25 cm),术中出血量少于对照组(284. 62±54. 21 vs. 397. 57±61. 49 ml),差异均具有统计学意义(P <0. 05);而两组手术时间比较(165. 28±33. 24 vs. 156. 39±30. 92 min),差异无统计学意义(P> 0. 05)。观察组患者的1、3年生存率97. 62%(41/42)、90. 48%(38/42)]均高于对照组88. 10%(37/42)、76. 19%(32/42)],但差异无统计学意义(P> 0. 05)。观察组患者的各项生活质量评分精神健康(75. 42±6. 87 vs 61. 30±4. 15分)、情感职能(81. 38±7. 15 vs. 73. 49±5. 76分)、社会功能(82. 67±5. 78 vs. 75. 42±4. 35分)、一般健康状况(79. 49±6. 17 vs.70. 31±5. 04分)、精力(84. 37±5. 45 vs. 74. 13±6. 07分)、生理职能(86. 52±6. 88 vs. 76. 93±6. 42分)、躯体疼痛(83. 46±7. 49 vs. 74. 33±5. 79分)、生理功能(70. 39±4. 31 vs. 61. 38±3. 56分)]均高于对照组,且差异具有统计学意义(P <0. 05)。结论 与传统开胸肺叶切除术相比,电视辅助胸腔镜下解剖性肺切除治疗I期肺癌手术损伤更小、短期生存率更高,且有助于提高患者术后生活质量水平,这对改善患者预后有重要意义,值得临床推广应用。

Clinical effect of video-assisted thoracoscopic anatomical pneumonectomy for stage I lung cancer

Objective To investigate the clinical effect of video-assisted thoracoscopic anatomical pneumonectomy for stageⅠlung cancer.Methods Using retrospective research methods,84 patients with stage I lung cancer treated from May 2015 to Jan 2017 at the Affiliated Tumor Hospital of Guangxi Medical University were selected,and the patients were divided into two groups according to different surgical methods:observation group and control group.42 cases each.Patients in the observation group were treated with video-assisted thoracoscopic anatomical pneumonectomy,and patients in the control group were treated with traditional thoracotomy.Changes in hospitalization time,incision length,intraoperative bleeding volume,surgical time,1-year and 3-year survival,and quality of life scores(SF-36 Life Scale)were compared between the two groups.Results The hospital stay of the observation group was shorter than that of the control group(6.13±1.46 vs.10.39±2.41 d),the length of the incision was shorter than that of the control group(4.38±1.09 vs.11.84±3.25 cm),and the intraoperative blood loss was less than that of the control group(284.62±54.21 vs.397.57±61.49 ml),the difference was statistically significant(P<0.05).While the operation time comparison between the two groups(165.28±33.24 vs.156.39±30.92 min),the difference was not statistically significant(P>0.05).The 1-and 3-year survival rates of patients in the observation group97.62%(41/42),90.48%(38/42)]were higher than those in the control group88.10%(37/42),76.19%(32/42)],But the difference was not statistically significant(P>0.05).Various quality of life scores of patients in the observation groupmental health(75.42±6.87 vs.61.30±4.15 points),emotional function(81.38±7.15 vs.73.49±5.76 points),social function(82.67±5.78 vs.75.42±4.35 points),general Health status(79.49±6.17 vs.70.31±5.04 points),energy(84.37±5.45 vs.74.13±6.07 points),physiological functions(86.52±6.88 vs.76.93±6.42 points),physical pain(83.46±7.49 vs.74.33±5.79 points),Physiological function(70.39±4.31 vs.61.38±3.56 points)]were higher than the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with traditional thoracotomy,TV-assisted thoracoscopic anatomical pneumonectomy for stage I lung cancer has less injury,higher short-term survival rate,and can help to improve the quality of life of patients after surgery.The prognosis is of great significance and worthy of clinical application.