胸腔镜与开胸肺叶切除术治疗肺癌患者的效果比较

Comparison of effects of thoracoscopic and thoracotomy lobectomy in treatment of patients with lung cancer

目的:比较胸腔镜与开胸肺叶切除术治疗肺癌患者的效果。方法:回顾性分析2018年5月至2020年5月该院收治的100例肺癌患者临床资料,根据手术方式不同将其分为对照组和观察组各50例。对照组采用开胸肺叶切除术治疗,观察组采用胸腔镜肺叶切除术治疗。比较两组手术相关指标[手术时间、术中出血量、术后引流量、引流时间、下床活动时间、术后住院时间、术后48 h视觉模拟评分法(VAS)评分]、治疗前后肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、呼气流量峰值(PEF)]水平、近期疗效,以及并发症发生率。结果:观察组手术时间、引流时间、下床活动时间、术后住院时间均短于对照组,术中出血量、术后引流量均少于对照组,VAS评分低于对照组,差异有统计学意义(P<0.05);术后,两组FVC、FEV_(1)、PEF水平均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05);随访1年,观察组局部复发率、远处转移率均低于对照组,1年内生存率高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为8.00%(4/50),低于对照组的24.00%(12/50),差异有统计学意义(P<0.05)。结论:胸腔镜肺叶切除术治疗肺癌患者可提高肺功能指标水平,延长生存时间,加快术后恢复,降低并发症发生率,效果优于开胸肺叶切除术治疗。

Objective: To compare effects of thoracoscopic and thoracotomy lobectomy in treatment of patients with lung cancer. Methods:The clinical data of 100 patients with lung cancer admitted to the hospital from May 2018 to May 2020 were retrospectively analyzed. They were divided into control group and observation group according to different surgical methods, 50 cases in each. The control group was treated with thoracotomy lobectomy, while the observation group was treated with thoracoscopic lobectomy. The operation-related indicator levels [operation time, intraoperative blood loss, postoperative drainage volume, drainage tube indwelling time, ambulation time, postoperative hospitalization time,postoperative 48 h visual analogue scale(VAS) score], the lung function indicator levels [forced vital capacity(FVC), forced expiratory volume in the first second(FEV_(1)), peak expiratory flow(PEF)] before and after the treatment, the short-term prognosis, and the incidence of complications were compared between the two groups. Results: The operation time, the drainage tube indwelling time, the ambulation time and the postoperative hospitalization time in the observation group were shorter than those in the control group, the intraoperative blood loss and the postoperative drainage volume were less than those in the control group, the VAS score was lower than that in the control group, and the differences were statistically significant(P<0.05). After the surgery, the levels of FVC, FEV_(1) and PEF in the two groups were higher than those before the surgery, those in the observation group were higher than those in the control group, and the differences were statistically significant(P<0.05). After 1 year of follow-up,the local recurrence rate and the distant metastasis rate of the observation group were lower than those of the control group, the survival rate within 1 year was higher than that of the control group, and the differences were statistically significant(P<0.05). Further, the incidence of complications in the observation group was 8.00%(4/50), which was lower than 24.00%(12/50) in the control group, and the difference was statistically significant(P<0.05). Conclusions: Thoracoscopic lobectomy for the lung cancer patients can improve the levels of lung function indicators, improve the short-term prognosis, and reduce the levels of operation-related indicators and the incidence of complications. Moreover, it is superior to thoracotomy lobectomy.