非小细胞肺癌患者微创手术短期和长期效果及相关因素研究

目的：分析非小细胞肺癌患者微创手术短期和长期效果及相关因素。方法选取60例非小细胞肺癌患者，随机分为两组，比较两组患者短期和长期疗效观察指标，并对胸腔镜组1年生存率的单因素、多因素进行分析。结果胸腔镜组手术时间为（143．2±20．1）min，切口长度为（4．3±1．2）cm，术中出血量为（119．7±23．4）ml，清扫淋巴结数为（10．2±3．7）个，术后住院时间为（7．4±3．2）d；常规组手术时间为（139．7±2．3）min，切口长度为（14．9±3．8）cm，术中出血量为（142．3±21．1）ml，清扫淋巴结数为（10．4±2．9）个，术后住院时间为（10．9±5．1）d。胸腔镜组与常规组切口长度、术中出血量及术后住院时间组间比较差异明显，具有统计学意义（ P＜0．05）。胸腔镜组Ⅰ期、Ⅱ期、Ⅲa期1年、3年生存率分别为（98．7％，86．3％）、（92．1％，58．4％）、（87．8％，36．2％）；常规组Ⅰ期、Ⅱ期、Ⅲa期1年、3年生存率分别为（98．4％，86．7％）、（92．3％，57．9％）、（88．1％，36．0％）。以上差异均无统计学意义（ P＞0．05）。单因素分析结果显示，患者年龄、性别、病理分期、纵膈淋巴结转移情况、清扫淋巴结个数、清扫淋巴结组数均为胸腔镜手术疗效的主要影响因素；多因素分析结果显示，病理分期、纵膈淋巴结转移情况、清扫淋巴结个数及清扫淋巴结组数是影响胸腔镜手术疗效的独立因素。结论胸腔镜手术能够取得良好的短期和长期效果，且手术疗效受多种因素影响。

Short-term and Long-term Efficacy of Minimally Invasive Surgery for Non-small Cell Lung Cancer Patients and Related Factors

Objective To study the short-term and long-term efficacy of minimally invasive surgery for non-small cell lung cancer patients and related factors.Methods 124 cases of non-small cell lung cancer patients were randomly divided into 2 groups,then the short-term and long-term efficacy of the 2 groups were compared,and single factor and multi-factors of 1-year sur-vival rate of the thoracoscopic group were analyzed.Results The surgery time was(143.2 ±20.1) min,incision length was(4.3 ±1.2) cm,blood loss was(119.7 ±23.4) mL,the number of lymph node dissection was(10.2 ±3.7),postoperative hospital stay time was(7.4 ±3.2) d in the thoracoscopic group,and in the conventional group,the operative time was(139.7 ±2.3) min,incision length was(14.9 ±3.8) cm,blood loss was(142.3 ±21.1) mL,the number of lymph node dissection was(10.4 ± 2.9),postoperative hospital stay was(10.9 ±5.1) d of,there was significant difference between the 2 groups in incision length, blood loss and postoperative hospital stay(P<0.05).The 1-year,3-year survival rates of stage Ⅰ,Ⅱ,Ⅲa in the thoracoscopic group were(98.7%,86.3%),(92.1%,58.4%),(87.8%,36.2%),respectively.The 1-year,3-year survival rates of stageⅠ,Ⅱ,Ⅲa in the conventional group were(98.4%,86.7%),(92.3%,57.9%),(88.1%,36.0%),there was no significant difference between the 2 groups(P>0.05).Univariate analysis showed that age,gender,pathological staging,mediastinal lymph node metastasis,the cleaning number of lymph nodes and cleaning groups of lymph node were main influencing factors of thoraco-scopic surgery;the multivariate analysis showed that pathology staging,mediastinal lymph node metastasis,number of lymph nodes dissection and groups of lymph node dissection were independent factors affecting thoracoscopic surgery.Conclusion Thoraco-scopic surgery can achieve good short-term and long-term efficacy,and effects are related to many factors.