探讨胸腔镜肺段切除术与胸腔镜肺叶切除术治疗早期肺癌的临床效果及预后影响

Exploring the clinical efficacy and prognostic impact of thoracoscopic lung segmentectomy and thoracoscopic lobectomy in the treatment of early lung cancer

目的:探讨胸腔镜肺段切除术、胸腔镜肺叶切除术治疗早期肺癌的临床效果。方法:选取北京市大兴区人民医院2021年8月-2022年7月收治的66例早期肺癌开展研究,将患者按照手术方案分组,各33例。其中肺段组采用胸腔镜肺段切除术治疗,肺叶组采用胸腔镜肺叶切除术治疗。比较两组手术一般情况、并发症率、肺功能评价、疼痛程度、炎性反应、12个月生存率。结果:两组手术出血量、淋巴结清除数量、手术时间对比(P>0.05);肺段组引流时间、住院时间短于肺叶组(P<0.05)。肺段组并发症率为9.09%(3/33),肺叶组并发症率24.24%(8/33),两组对比(P>0.05)。术前两组肺功能指标肺活量(FVC)、第1s用力呼气容积(FEV1)、最大通气量(MVV)对比(P>0.05);术后肺段组FVC、FEV1、MVV水平高于肺叶组(P<0.05)。术前两组视觉模拟评分法(VAS)对比(P>0.05);术后肺段组VAS水平低于肺叶组(P<0.05)。术前两组C反应蛋白(CRP)、前白蛋白(PA)对比(P>0.05);术后肺段组CRP低于肺叶组,PA高于肺叶组(P<0.05)。肺段组12个月生存率为93.94%,肺叶组12个月生存率为84.85%,两组对比(P>0.05)。结论:胸腔镜肺段切除术在早期肺癌的治疗中相较肺叶切除术,能够缩短康复时间,改善肺功能,减轻炎性反应,有助于患者获得更为理想的预后。

objective:To explore the clinical effects of thoracoscopic lung segmentectomy and thoracoscopic lobectomy in the treatment of early lung cancer.Methods:A study was conducted on 66 cases of early lung cancer admitted from August 2021 to July 2022.Patients were divided into surgical groups,with 33 cases in each group.The lung segment group was treated with thoracoscopic lobectomy,while the lung lobe group was treated with thoracoscopic lobectomy.Compare the general situation,complication rate,pulmonary function evaluation,pain level,inflammatory response,and 12-month survival rate between two groups of surgeries.Results:Comparison of surgical bleeding volume,lymph node clearance quantity,and surgical time between the two groups(p>0.05);The drainage time and hospitalization time in the lung segment group were shorter than those in the lung lobe group(p<0.05).The incidence of complications in the lung segment group was 9.09%(3/33),and in the lobar group was 24.24%(8/33),with a comparison between the two groups(p>0.05).Comparison of lung function indicators such as vital capacity(FVC),forced expiratory volume(FEV1)in the first second,and maximum ventilation volume(MVV)between the two groups before surgery(p>0.05);The levels of FVC,FEV1,and MVV in the postoperative lung segment group were higher than those in the lobar group(p<0.05).Comparison of Visual Analog Scale(VAS)between two groups before surgery(p>0.05);The VAS level in the postoperative lung segment group was lower than that in the lobar group(p<0.05).Comparison of C-reactive protein(CRP)and prealbumin(PA)between the two groups before surgery(p>0.05);After surgery,the CRP in the segmental lung group was lower than that in the lobar lung group,and the PA was higher than that in the lobar lung group(p<0.05).The 12 month survival rate of the lung segment group was 87.88%(29/33),and the 12 month survival rate of the lung lobe group was 75.76%(25/33),with a comparison between the two groups(p>0.05).Conclusion:Compared with lobectomy,thoracoscopic lung segmentectomy can shorten recovery time,improve lung function,alleviate inflammatory reactions,and help patients achieve a more ideal prognosis in the treatment of early lung cancer.