胸腔镜下肺段切除术对早期NSCLC患者肺通气功能的影响

The Effect of Thoracoscopic Lung Segmentectomy on Lung Ventilation Function in Early NSCLC Patients

目的分析胸腔镜下肺段切除术在早期非小细胞肺癌(NSCLC)患者中的应用应用效果。方法选取该院2020年5月—2023年5月收治的78例早期NSCLC患者为研究对象,按随机数字表法将其分为对照组与观察组,各39例。对照组行胸腔镜下肺叶切除术,观察组行胸腔镜下肺段切除术,两组术后均随访3个月。对比两组患者的围术期指标、肺通气功能及并发症发生情况。结果观察组术中出血量为(74.28±4.20)mL,术后引流量为(567.45±30.37)mL,均少于对照组的(85.69±5.37)mL、(996.75±34.25)mL,手术时间为(196.37±24.25)min,长于对照组的(183.75±20.49)min,拔管时间为(4.56±0.67)d、住院时间为(6.53±1.23)d,均短于对照组的(5.79±1.23)d、(7.95±1.66)d,术后疼痛视觉模拟评分为(5.01±0.95)分,低于对照组的(5.79±1.23)分,并发症发生率为5.13%,低于对照组的23.08%,组间差异有统计学意义(P<0.05)。术前,两组用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、呼气流量峰值(PEF)相比,组间差异无统计学意义(P>0.05)。术后,观察组FVC为(2.53±0.26)L,FEV_(1)为(2.04±0.25)L,PEF为(3.77±0.35)L/s,均大于对照组的(2.01±0.17)L、(1.69±0.21)L、(3.15±0.27)L/s,组间差异有统计学意义(P<0.05)。结论胸腔镜下肺段切除术手术时间较长,但其创伤更小,患者术后恢复快,能够减轻对早期NSCLC患者肺通气功能的影响,且并发症更少,临床可推广应用。

Objective To analyze the effectiveness of thoracoscopic lung segmentectomy in patients with early non-small cell lung cancer(NSCLC).Methods 78 patients with early-stage NSCLC admitted to our hospital from May 2020 to May 2023 were selected as the study objects,and were divided into a control group and an observation group according to random number table method,with 39 cases in each group.The control group underwent thoracoscopic lobectomy and the observation group underwent thoracoscopic segmental resection.Both groups were followed up for 3 months.The perioperative indexes,pulmonary ventilation function and complications were compared between the two groups.Results The intraoperative blood loss and postoperative drainage volume in the observation group were(74.28±4.20)mL and(567.45±30.37)mL,both of which were less than(85.69±5.37)mL and(996.75±34.25)mL in the control group,and the operative time was(196.37±24.25)min,which was longer than(183.75±20.49)min of the control group,extubation time(4.56±0.67)d and hospital stay(6.53±1.23)d,which were shorter than(5.79±1.23)d and(7.95±1.66)d of the control group,the Visual Analog Score of postoperative pain was(5.01±0.95)points,which was lower than(5.79±1.23)points of the control group,the complication rate was 5.13%,which was lower than 23.08%of the control group,the differences were statistically significant(P<0.05).Before surgery,there were no significant differences in forced vital capacity(FVC),forced expiratory volume in the first second(FEV_(1))and peak expiratory flow(PEF)between the two groups(P>0.05).After operation,FVC,FEV_(1) and PEF in the observation group were(2.53±0.26)L,(2.04±0.25)L and(3.77±0.35)L/s,which were all greater than(2.01±0.17)L,(1.69±0.21)L and(3.15±0.27)L/s in the control group,the differences between groups were statistically significant(P<0.05).Conclusion Thoracoscopic lung segmentectomy has a longer surgical time but smaller trauma,faster postoperative recovery,and can reduce the impact on lung ventilation function in early NSCLC patients with fewer complications.It can be widely applied in clinical practice.