外科治疗非小细胞肺癌280例临床分析

Clinical effect of surgical treatment for non-small cell lung cancer in 280 cases

目的探索不同的外科手术切除方式治疗非小细胞癌的安全性和远期疗效。方法选取我院2002年1月至2007年1月手术治疗的280例非小细胞癌患者,其中全肺切除组180例,肺叶袖状切除组100例,将两种手术方式治疗的术后并发症发生率、死亡率以及5年生存率进行比较分析。结果全肺切除后并发症发生率21.1%,袖状切除后并发症发生率10.9%,两组差异有统计学意义(P<0.05);全肺切除后死亡率3.9%,袖状切除后死亡率3.0%,两组差异无统计学意义(P>0.05);全肺切除5年生存率30.2%,袖状切除44.3%,组间差异有统计学意义(P<0.05),其中N0、N1分型患者5年生存率袖状切除优于全肺切除(P<0.05),N2型患者5年生存率两组差异无统计学意义(P>0.05)。两组患者的术后复发率差异无统计学意义(P>0.05)。结论对非小细胞癌的治疗,采用肺叶袖状切除的总体治疗效果要优于全肺切除术。

Objective To explore the clinical security and long-term therapeutic effects of different surgical treatments on non-small cell lung cancer.Methods Totally 280 patients with non-small cell lung cancer treated in our hospital from January 2002 to January 2001 were selected.Among these patients,180 cases were treated by pneumonectomy and the other 100 cases were treated by sleeve lobectomy.The complication incidence,mortality rate and five-year survival rate of the two surgical methods were compared after the operation.ResultsThe complication incidences of pneumonectomy and sleeve lobectomy were 21.1% and 10.9% respectively,with statistical differences,P0.05.The mortality rate was 3.9% in pneumonectomy and 3% in sleeve lobectomy,without statistical differences,P0.05.The five-year survival rates of pneumonectomy and sleeve lobectomy were 30.2% and 44.3% respectively,P0.05.The five-years surviual rate was better in patients treated by sleeve lobectomy than those treated by pneumonectomg among N0 and N1 type,P0.05.The five-year survival rate of N2 type was not statistically different between the two methods,P=0.087.There was no difference in complication recurrence rate between the two methods,P0.05.Conclusion To treat non-small cell lung cancer,the clinical effect of sleeve lobectomy is better than pneumonectomy.