支气管袖状切除术与全肺切除术治疗老年非小细胞肺癌临床疗效对比研究

目的：探讨支气管袖状切除术与全肺切除术治疗老年非小细胞肺癌（ NSCLC）的临床疗效。方法选择2009年8月—2014年8月入住我院的63例老年 NSCLC 患者，按照术式分为对照组31例与观察组32例，均于全麻条件下，分别行全肺切除术与支气管袖状切除术治疗。比较两组的手术相关指标、肺功能、生活质量评分及免疫功能等临床指标。结果观察组术中出血量及术后住院时间均显著小于对照组（ P ﹤0.05）；两组术后肺功能相关指标水平和体液免疫指标水平较术前均显著降低（P ﹤0.05），观察组术后上述指标水平均显著高于对照组（ P ﹤0.05）；两组术后 SF-36生活量表各维度（躯体功能、心理功能、社会功能及物质功能）评分均显著高于术前（ P ﹤0.05），且观察组术后上述各维度评分均显著高于对照组（P ﹤0.05）。结论与全肺切除术相比，支气管袖状切除术治疗老年 NSCLC患者的临床疗效更显著，对患者肺功能、免疫功能影响更小。

A Comparative Study on Clinical Curative Effect of Bronchial Sleeve Resection and Pneumonectomy in Treat-ment of Elderly Patients with Non-small-cell Lung Cancer

Objective To investigate clinical curative effects of bronchial sleeve resection and pneumonectomy in treatment of elderly patients with non-small-cell lung cancer(NSCLC). Methods A total of 63 elderly patients with NSCLC during Augest 2009 and Augest 2014 were divided into control group(n = 31)and observation group(n = 32)in accordance with surgical methods. The two groups underwent pneumonectomy and bronchial sleeve resection respectively under general anesthesia . Clinical indexes such as related indexes of surgery,lung function,life quality score and immu-nological function were compared in two groups. Results Values of intraoperative blood loss and postoperative hospital stay in observation group were significantly lower than those in control group( P ﹤ 0. 05). Levels of postoperative lung function and postoperative humoral immune indexes were significantly higher than those before the surgery in two groups (P ﹤ 0. 05),and the above levels after surgery in observation group were significantly higher than those in control group (P ﹤ 0. 05);postoperative dimension scores of SF-36 life scale(physical,psychological,social and material functions) were significantly higher than those before surgery in two groups(P ﹤ 0. 05),and the above scores after surgery in obser-vation group were significantly higher than those in control group( P ﹤ 0. 05). Conclusion Bronchial sleeve resection can achieve better curative effect but less effect on lung and immune functions in treatment of elderly patients with NSCLC than those by pneumonectomy.