文章摘要
电视胸腔镜下肺叶切除治疗非小细胞肺癌的临床疗效及安全性分析
Analysis of efficacy and safety of video-assisted thoracoscopic lobectomy in treatment of non-small cell lung cancer
投稿时间：2018-04-24  
DOI：10.3969/j.issn.1000-0399.2018.11.015
中文关键词: 电视胸腔镜  肺叶切除术  传统开胸  非小细胞肺癌  并发症
英文关键词: Video-assisted thoracoscopic surgery  Lobectomy  Traditional thoracotomy  Non-small cell lung cancer  Complication
基金项目:
作者单位
王德昌 473010 河南省南阳市第一人民医院心胸外科 
水清 473010 河南省南阳市第一人民医院心胸外科 
陈方 473010 河南省南阳市第一人民医院心胸外科 
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中文摘要:
      目的 分析电视胸腔镜下肺叶切除治疗非小细胞肺癌的临床疗效及安全性。方法 选取2016年1月至2018年1月南阳市第一人民医院收治的126例非小细胞肺癌患者，根据入院时间顺序编号，按照随机数字表法分为对照组和观察组，每组各63例，其中对照组予以传统开胸肺叶切除术，观察组予以电视胸腔镜下肺叶切除术。对比两组患者围手术期指标观察两组患者手术前后肺功能及血气指标、术后并发症发生情况。结果 观察组切口长度、住院时间、下床活动时间短于对照组，差异有统计学意义（P<0.05），术中出血量、术后引流量低于对照组，手术时间长于对照组，差异均有统计学意义（P<0.05）。两组术后用力肺活量占预计值百分比（FVC%）、第1秒用力呼气容积占预计值百分比（FEV1%）、一氧化碳弥散量占预计值百分比（DLCO%）、动脉血二氧化碳分压（PaO2）均低于术前，动脉血氧分压（PaCO2）高于术前，差异均有统计学意义（P<0.05），且观察组上述指标术后均高于对照组，差异均有统计学意义（P<0.05）；观察组术前、术后FVC%、FEV1%、DLCO%、PaCO2降低程度低于对照组，PaO2提高程度高于对照组，差异均有统计学意义（P<0.05）。观察组术后并发症总发生率低于对照组，差异有统计学意义（P<0.05）。结论 电视胸腔镜下肺叶切除治疗非小细胞肺癌安全、有效，术后并发症少。
英文摘要:
      Objective To analyze the clinical efficacy of video-assisted thoracoscopic lobectomy in the treatment of non-small cell lung cancer. Methods Totally 126 patients with non-small cell lung cancer admitted to our hospital from Jan 2016 to Jan 2018 were selected, then numbered by admission time sequence and divided into control group and observation group according to random number table, with 63 cases in each group. The control group received traditional thoracoscopic lobectomy, while the observation group received video-assisted thoracoscopic lobectomy. The length of incision, intraoperative blood loss, volume of postoperative drainage, number of lymph node dissection, operation time, extubation time, length of hospital stay and time of out of bed activity were compared between the two groups. Changes in lung function and blood gas index before and after surgery, postoperative complications were observed in the two groups. Results The length of incision, length of hospital stay, and time of out of bed activity in observation group were significantly shorter than those in control group (P<0.05), while intraoperative blood loss and volume of postoperative drainage were significantly lower than those in control group, and the operative time was significantly longer than that in control group (P<0.05). The forced vital capacity total predicted value (FVC%), forced expiratory volume in one second total predicted value (FEV1%), the percent predicted diffusing capacity of the lung for carbon monoxide (DLCO%) and partial pressure of arterial carbon dioxide (PaO2) were significantly lower than those before the operation, and partial pressure of arterial oxygen (PaCO2) was higher than those before the operation in two groups (P<0.05). The above indexes in observation group were significantly higher than those in control group (P<0.05). The difference values of FVC%, FEV1%, DLCO%, PaCO2 before and after operation in observation group were significantly lower than those in control group, and the difference value of PaO2 was significantly higher than that in control group (P<0.05). The total incidence of postoperative complications was significantly lower than that in observation group (P<0.05). Conclusion Video-assisted thoracoscopic lobectomy is effective in the treatment of non-small cell lung cancer, with less postoperative complications and higher safety.
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