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全胸腔镜下肺叶切除术治疗肺癌的临床研究
引用本文:叶菊花,时红云. 全胸腔镜下肺叶切除术治疗肺癌的临床研究[J]. 癌症进展, 2016, 14(6): 559-562. DOI: 10.11877/j.issn.1672-1535.2016.14.06.18
作者姓名:叶菊花  时红云
作者单位:黄冈市中心医院 手术室,湖北 黄冈,438000;黄冈市中心医院 保健科,湖北 黄冈,438000
摘    要:目的:探讨全胸腔镜下肺叶切除术治疗肺癌的临床效果。方法选择接受肺叶切除术的肺癌患者88例,按照随机数字表法分为全胸腔镜组44例与对照组44例,全胸腔镜组行全胸腔镜肺叶切除术,对照组行常规开胸肺叶切除术。比较两组手术相关指标、血流动力学指标、免疫细胞水平、术后并发症及随访结果。结果全胸腔镜组术中出血量、引流管留置时间、引流管引流量、术后疼痛时间、术后下床时间显著低于对照组,手术时间显著高于对照组,差异均有统计学意义(P﹤0.05)。单肺通气30 min后、单肺通气结束后、手术结束时,全胸腔镜组CI、CO、MAP、SV水平低于对照组,差异有统计学意义(P﹤0.05)。全胸腔镜组手术后7 d NK、CD4+、CD8+、CD4+/CD8+免疫细胞水平高于对照组手术后7 d水平,差异有统计学意义(P﹤0.05)。全胸腔镜组术后并发症发病率(4.55%)低于对照组(27.27%),差异有统计学意义(P﹤0.05)。全胸腔镜组局部复发率、远处转移率、3年生存率分别为4.55%、18.18%、88.64%,对照组分别为11.36%、25.00%、75.00%,两组比较差异无统计学意义(P﹥0.05)。结论全胸腔镜肺叶切除术治疗肺癌侵袭性小,可有效维护肺癌患者血流动力学、免疫系统的稳定性,降低术后并发症发病率、复发率、远处转移率,有利于患者术后康复。

关 键 词:全胸腔镜术  开胸术  肺叶切除术  肺癌

Clinical study of thoracoscopic lobectomy in the treatment of lung cancer
YE Ju-hua,SHI Hong-yun. Clinical study of thoracoscopic lobectomy in the treatment of lung cancer[J]. Oncology Progress, 2016, 14(6): 559-562. DOI: 10.11877/j.issn.1672-1535.2016.14.06.18
Authors:YE Ju-hua  SHI Hong-yun
Abstract:Objective To investigate the clinical effect of thoracoscopic lobectomy in the treatment of lung cancer. Method 88 cases of lung cancer patients were randomized into thoracoscopic lobectomy (TL) group (n=44) and control group (n=44) according to a random number table, and were administered with thoracoscopic lobectomy or conventional open lobectomy, respectively. The measures related with surgery, hemodynamics, immune cells, postoperative complica-tions and outcomes of the two groups were compared. Result The intraoperative blood loss, tube dwell time, drainage volume, pain and ambulation were all lower in TL group than those in control group (all P<0.05). At the time of 30 min after single-lung ventilation, completion of single-lung ventilation, and completion of surgery, the CI, CO, MAP, SV lev-els in TL group were lower than that in control group, with significant differences observed (P<0.05);In 7 d after surgery, the levels of NK CD4+, CD8+, and CD4+/CD8+were all higher in TL group than those in control group, which were of sta-tistical significance (P<0.05). The incidence of postoperative complications (4.55%) in TL group was significantly lower than that of the control group (27.27%) (P<0.05). The recurrence rate, distant metastasis rate, 3-year survival rate were 4.55%, 18.18%and 88.64%in TL group, and were 11.36%, 25.00%, and 75.00%in control group, respectively, with no significant difference observed (P>0.05). Conclusion Thoracoscopic lobectomy is less invasive in treating lung cancer, and may effectively maintain stable hemodynamics and immune function for lung cancer patients, which is a feasible pro-cedure with low postoperative complication rate, recurrence rate, as well as distant metastasis rate, and is beneficial in pro-moting recovery.
Keywords:thoracoscopic surgery  thoractomy  lobectomy  lung cancer
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