电视胸腔镜手术在胸部肿瘤治疗中的近期疗效研究

目的 探讨电视胸腔镜手术（VATS）治疗胸部肿瘤的近期疗效.方法 将60例胸部肿瘤患者随机分成VATS组30例和传统开胸手术组（TH组）30例,对两组患者予以VATS和TH治疗胸部肿瘤,比较两组患者的围术期情况,术前术后血清CRP、IL-6和TNF-α水平变化,并发症发生率及术后病人对手术满意度.结果 VATS组患者手术切口、术中出血量、术后引流量、术后镇痛药使用量和住院时间均小于TH组,差异具有统计学意义（P〈0.05）;两组患者术后血清CRP、IL-6和TNF-α水平均显著高于术前,差异具有统计学意义（P〈0.05）;VATS组患者术后血清CRP、IL-6和TNF-α水平均低于TH组,差异具有统计学意义（P〈0.05）;VATS组术后并发症发生率低于TH组,差异具有统计学意义（P〈0.05）;VATS组患者对手术满意度高于TH组,差异有统计学意义（P〈0.05）.结论 VATS治疗胸部肿瘤手术创伤较小,机体急性炎症反应较轻,免疫功能得到改善,患者术后并发症发生率降低,近期疗效显著,值得临床推广.

Research on the Recent Curative Effect of Video-Assisted Thoracoscope Surgery in the Treatment of Thoracic Cancer

Objective To explore the recent curative effect of the video-assisted thoracoseope surgery（VATS） in the treatment of thoracic cancer. Methods 60 patients with thoracic cancer were randomly divided into the VATS group（30 cases） and traditional thoraeotomy surgical group（TH group with 30 cases）. Patients of two groups were compared from the perspective of perioperative conditions, pre-operation and post-operation serum CRP, IL-6 and TNF-α level changes, complications of surgery and postoperative satisfaction. Results Operative incision of VATS group, intraoperative blood loss, postoperative drainage and postoperative analgesic usage and the length of hospital stay were less than TH group, the differences were significant（P〈0.05）; the postoperative serum CRP, IL-6 and TNF-α levels of both groups were significantly higher than that of the preoperative, the differences were significant （P〈0.05）. In VATS group, the postoperative serum CRP, IL-6 and TNF-α levels were lower than in TH group, the differences were significant（P〈0.05） ; the postoperative complications of the VATS group is lower than TH group, the differences were significant（P〈0. 05）; the satisfaction of VATS group patients is higher than TH group, the difference was statistically significant（P〈0.05）. Conclusion The video-assisted thoracoscope surgery has many advantages, including the smaller cut, the less acute inflammation the immune function, and the few postoperative complications. The curative effect of VATS is distinct and it is worth of clinical promotion.