胸腔镜下肺癌根治术40例临床疗效分析

目的：探讨应用胸腔镜根治肺癌的临床疗效。方法：收集本院胸外科2010年1月至2013年6月应用胸腔镜手术治疗的肺癌患者40例。男24例，女16例；年龄27~78岁。另选择我院胸外科行开胸手术治疗的肺癌患者50例作为对照。胸腔镜组采用胸腔镜下手术，开胸组采用传统开胸法手术。记录两组患者手术操作时间、术中出血量、术后胸腔引流量、引流拔管时间、平均住院时间及术后疼痛程度、术后并发症发生情况。结果：两组患者手术操作时间差异无统计学意义（P >0.05）。术中出血量、术后胸腔引流量、引流拔管时间及平均住院时间比较差异均有统计学意义（P 均<0.05）。淋巴结清扫个数：胸腔镜组清扫（13.5±2.4）个，开胸组清扫（12.8±3.2）个，两组比较差异无统计学意义（P >0.05）。两组术后疼痛程度、并发症比较差异均有统计学意义（P 均<0.05）。术后随访6个月~3年，胸腔镜组复发3例，复发率为7.5%，开胸组复发5例，复发率为10.0%，两组比较差异无统计学意义（P <0.05）。结论：胸腔镜肺癌根治术在淋巴结系统清扫上的效果与传统开胸手术相比无差异，远期生存率亦相似，但其术中出血量减少、引流管拔管时间缩短、住院时间缩短、并发症明显减少等近期疗效的优势明显好于开胸手术，胸腔镜下肺癌根治术值得临床推广。

Clinical curative effect of 40 cases with lung cancer treated under the thoracoscope

Objective:To explore the effect of thoracoscope on lung cancer. Methods:40 cases of lung cancer pa-tients,twenty - four male cases,16 cases female. Aged 27 to 78 years old,50 cases as control. Results:Operation time of two groups had no difference(P > 0. 05). Intraoperative blood loss,postoperative chest flow and drainage tube drawing time and the average hospitalization time were different(all P < 0. 05). Number of lymph node cleaning:Cleaning 13. 5 ± 2. 4 a thoracoscope group,cleaning thoracotomy group 12. 8 ± 3. 2,P > 0. 05. The degree of postoper-ative pain,complications in both groups were differenct(all P < 0. 05). Conclusion:On the lymph node cleaning of thoracoscope lung cancer radical compared with the traditional open heart surgery was not different,the long - term survival rate is similar,but the intraoperative blood loss reduction,drainage tube decannulation time was shortened, shorten hospitalization time,less complications.