电视辅助胸腔镜手术治疗周围型非小细胞肺癌的临床观察

目的探讨电视辅助胸腔镜手术治疗周围型非小细胞肺癌的疗效。方法回顾性分析74例周围型非小细胞肺癌患者的临床资料，按照手术方式不同分为胸腔镜组（观察组）与开胸手术组（对照组），比较2组患者围手术期情况、复发率及3年生存率。结果观察组手术时间长于对照组，2种手术方式术中淋巴结清扫个数无显著性差异，但观察组术中失血量、术后引流时间、疼痛评分、术后下床活动时间以及并发症发生率均低于对照组（P〈0．05）。术后24h2组患者CRP、TNF—α以及IL-6水平较术前升高，但观察组升高幅度均显著低于对照组（P〈0．05）。术后中位随访时间39个月，2组患者复发率及总生存率无显著性差异（P〉0．05）。结论电视辅助胸腔镜治疗周围型非小细胞肺癌创伤小、急性期反应低，疗效肯定，可作为常规治疗方式。

Clinical Observation of Video-Assisted Thoracoscopic Lobectomy for Peripheral Non-Small Cell Lung Cancer

Objective To explore the efficacy of video-assisted thoracoscopic lobectomy for peripheral non-small cell lung cancer. Methods Clinical data of 74 cases of peripheral non-small cell lung cancer patients were retrospectively analyzed. 34 patients who received thoracoscopic lobectomy was the control group and 40 patients who received conventional posterolateral thoracotomy was the control group. Perioperative clinical parameters, recurrence and 3-year survival rates of the 2 groups were compared. Results The operation time in the observation group was longer than that of the control group. The number of lymph node dissection between the 2 groups had no obvious difference. But the intraoperative bleeding, postoperative drainage time, pain score, time of leaving bed, complications of the observation group were lower than that of the control group（ P 〈 0.05 ）. Postopera- tive CRP ~TNF-ct and IL-6 levels of the 2 groups both increased. But the growth in the observation group was significantly lower than that of the control group（ P 〈 0.05 ）. After a median follow-up of 39 months ,there was no obvious difference in recurrence and 3-year survival rate between the 2 groups （ P 〉 0.05 ）. Conclusion Video-assisted thoracoscopic lobectomy for peripheral non-small cell lung cancer has the virtue of small trauma ,fewer acute reactions and good efficacy, it can be used as conventional treatment.