胸腔镜肺叶切除术及淋巴清扫术对不同病理类型肺癌患者肺功能、生存率的影响

目的 探讨胸腔镜肺叶切除术及淋巴清扫术对不同病理类型肺癌患者肺功能、生存率的影响。方法 选取2009年6月—2011年9月在我院接受胸腔镜肺叶切除术及纵隔淋巴清扫术的125例肺癌患者作为研究对象,根据病理类型分为腺癌组(AG)、鳞癌组(SG)、大细胞癌组(LG),观察手术前后临床效果、肺功能指标及生存率等。结果 LG组在手术时间、术中出血量、术后胸管引流量方面均高于SG组、AG组(P＜0.05);AG组在术中出血量、术后胸管引流量及术后恢复时间方面均高于SG组(P＜0.05);LG组在FVC%方面高于AG组(P＜0.05);LG组、AG组在FVC%、FEF50%、FEF75%方面与SG组有统计学差异(P＜0.05);18个月后各组患者生存率均低于第12个月的随访结果(P＜0.05),SG组在12、18个月的生存率均高于AG组、LG组(P＜0.05)。结论 胸腔镜肺叶切除术联合淋巴结清扫术治疗不同病理类型肺癌患者时,大细胞癌手术治疗时手术时间、术中出血量、术后胸管引流量方面均高于腺癌、鳞癌患者;鳞癌患者生存率及身体评价均高于其他各组。

Lung function and the survival rate of impact thoracoscopic lobectomy and lymph node dissection for pa-tients with different pathological types of lung cancer

Objective To investigate the VATS lobectomy and lymph node dissection impact on lung function and the survival rate in patients with different pathological types of lung cancer.Methods One hundred and twenty five cases of lung cancer patients underwent laparoscopic lobectomy and mediastinal lymph node dissection as research subjects from June 2009 to September 2011 in our hospital.The patients were divided into pathology group(AG),squamous cell carcinoma(SG) and large cell carcinoma group(LG)according to the type of cancer.The clinical effects were observed before and after surgery,lung function and survival rate.Results LG Group in operative time,blood loss and postoperative chest tube drainage were higher than SG group AG group(P＜0.05);AG group blood loss,postoperative chest tube drainage,blood transfusion after surgery and postoperative recovery times were higher than the SG group(P＜0.05);LG group was higher than AG group(P＜0.05)in terms of FVC%;LG Group,AG group in FVC%,FEF50%,FEF75% respects SG group were significantly different(P＜0.05);18-month survival rate of patients in each group after the first follow up Results of less than 12 months(P＜0.05).SG group at 12,18-month survival rates were higher than AG group and LG group(P＜0.05).Conclusion Laparoscopic lobectomy combined treatment of pathological lymph node dissection in patients with different types of lung cancer,large cell carcinoma surgery operative time,blood loss and postoperative chest tube drainaged are higher than adenocarcinoma,squamous cell carcinoma;squamous cell survival and physical evaluation of patients are higher than the other groups.