肺GGO改变特征为主的早期肺癌微创精准治疗的疗效

The Efficacy of Minimally Invasive Precise Treatment for Early Lung Cancer Characterized by Lung GGO Change

目的探讨肺GGO改变特征为主的早期肺癌患者微创精准治疗的疗效、可行性与安全性。方法筛选早期肺癌毛玻璃(GGO)样变患者,共60例,随机数表法分为两组。观察组患者采取CT引导下Hook-wire术前定位胸腔镜微创切除术(VATS),对照组患者行传统开胸肺癌根治术。比较两组患者手术情况、手术相关指标差异、术后并发症以及术后常规随访情况差异。结果 VATS切除术成功率100%,CT引导Hook-wire明确定位率为为100%,平均用时(9.87±7.41)min。观察组患者手术时间、术中出血量、住院时间、胸管留置时间均明显少于对照组(P<0.05)。观察组并发症发生率19.56%,显著低于对照组(P<0.001)。术后1 d、1 w VAS评分观察组患者均显著低于对照组(P<0.05)。术后6个月~3年随访,观察组患者远期生存指数与对照组比较差异无统计学意义(P>0.05),与开胸肺癌根治术远期疗效呈一致性。结论采取CT引导下Hook-wire术前定位胸腔镜微创切除术具有临床可操作性、较高的安全性与近期疗效,微创精准治疗有效减少患者手术带来的疼痛与术后并发症的发生。

Objective To investigate the efficacy, feasibility and safety of minimally invasive surgery for early stage lung cancer patients with lung GGO changes. Methods 60 cases of early lung cancer （GGO） glass amyloidosis patients were randomly divided into 2 groups. The observation group were taken CT Hook-wire guided preoperative localization of minimally invasive thoracoscopic resection （ VATS）, the control group underwent thoracotomy lung resection. Surgery, surgery related indicators, post- operative complications and routine follow-up of the 2 groups were compared. Results VATS surgery success rate of 100%, CT guided Hook-wire clear positioning rate was 100% and the average time （9.87 ＋ 7.41 rain）. The operation time,blood loss, length of stay, and indwelling time of the observation group were significantly less than those of the control group （ P 〈 0.05 ）. The complication rate of the observation group was significantly lower than the control group,19.56% （P 〈0.001 ） Postoperative 1D and 1 wVAS scores of patients in the observation group were significantly lower than those of the control groups （P 〈 0.05 ）. After 6 months to 3 years follow-up, the survival index of the observation group was the same as the control group, there had no significant difference （P 〉 0.05 ） ,was consistent with the long-term curative effect of open chest lung cancer. Conclusion Take CT Hook-wire guided preoperative localization of minimally invasive thoracoscopic resection is safe in clinical operation, high efficacy and safety, minimally invasive treatment can effectively reduce the occurrence of pain and precise surgery caused complications.