单向式全胸腔镜肺叶切除术治疗非小细胞肺癌的临床效果研究

Study on the Clinical Efficacy of Single-direction VATS Lobectomy in Treatment of Non-small Cell Lung Cancer

目的探讨单向式全胸腔镜下非小细胞肺癌根治术的临床效果。方法选择2009年1月至2010年1月在临朐县人民医院治疗的非小细胞肺癌患者43例,其中通过全胸腔镜下传统式手术17例(对照组),全胸腔镜下单向式手术26例(观察组)。比较两组患者的手术时间、术中出血量、纵隔淋巴结清扫的数量、术后胸腔引流量和生存率的改变。结果两组均无手术死亡患者,观察组胸腔引流量、术中出血量、胸腔引流时间、早期下床活动时间均低于对照组(P<0.05);对照组使用哌替啶患者的比率高于观察组(P<0.05);术后随访41例患者,失访2例,随访期间观察组和对照组分别死亡2例和3例,但差异无统计学意义(P>0.05)。结论单向式全胸腔镜肺叶切除术是一种安全、有效的手术方式,且创伤更小、恢复快,是治疗早期非小细胞肺癌的可靠方法。

Objective To investigate the clinical effect of single-direction VATS lobectomy in treatment of non-small cell lung cancer.Methods 43 cases of non-small cell lung cancer who received thoracic surgery Linqu County People′s Hospital from January 2009 to January 2010 were selected,and randomly divided into observation group（26 cases）and control group（17 cases）.The control group were treated with routine posterior lateral open thoracotomy and the observation group were treated with single-direction VATS lobectomy.The clinical features,such as operative time,operative blood loss,the number of systematic dissected lymph nodes,postoperative drainage quantity and survival rate werecompared.Results No operative death in the two groups.The pleural drainage and blood loss of the observation group were less than the control group,chest drainage time,early ambulation time earlier than the control group（P0.05）.The rate of using Dolantin in the control group was significantly higher than the observation group（P0.05）.41 patients were followed up after operation for 3 to 24 months.2 were lost,there were 2 and 3 cases of death in observation group and control group during the follow-up respectively,but the difference was not statistically significant（P0.05）.Conclusion The single-direction VATS lobectomy is a safe and effective procedure for the resection of non-small cell lung cancer with smaller trauma.