完全胸腔镜下解剖性肺段切除术与肺叶切除术术后肺功能的比较

The comparison of the pulmonary function after completely anatomic thoracoscopic segmentectomy versus lobectomy

目的:比较完全胸腔镜下解剖性肺段切除术与肺叶切除术两种手术方式对患者肺功能的影响。方法:2012年11月回顾性选取完全胸腔镜下的肺部手术治疗肺部小结节(直径≤3 cm)35例,其中肺段切除15例(切除肺段的数目<3段),肺叶切除术20例。比较两组患者术后半年的肺功能变化,观察指标包括第1秒用力呼吸容积的实测值/预计值百分比(FEV1)、用力肺活量的实测值/预计值百分比(FVC)、分钟最大通气量的实测值/预计值百分比(MVV)。结果:完全胸腔镜下解剖性肺段切除术组术后半年肺功能FEV1(84.53%±13.43%)较肺叶切除术组(76.19%±8.51%)提高,差异有统计学意义(P<0.05);两组术后肺功能在FVC%、MVV%上差异无统计学意义(P>0.05);两组患者术后均未出现并发症、复发及死亡。结论:在完全胸腔镜下手术治疗肺部小结节(直径≤3 cm)时,行肺段切除数目少于3段的解剖性肺段切除术较肺叶切除术,术后可以更好地保留患者的肺功能。

Objective：To compare the pulmonary function after this two kind of operation under video-assisted thoracoscopic surgery（VATS）,segmentectomy and lobectomy,on the treatment of small pulmonary nodule（the diameter ≤3cm）.Methods：From Nov.2010 to Mar.2012,15patients underwent VATS segmentectomy and 20 underwent VATS lobectomy.The preoperative and postoperative pulmonary function at six months,included FEV1%,FVC%,MVV%,was compared between the two groups.Results：The postoperative FEV1% was better in segmentectomy group（84.53% ± 13.43） than that in lobectomy group（76.19% ± 8.51%）（P〈0.05）.There were no significant differences on the postoperative FVC% and MVV% between the two groups.No death and local recurrence occurred in two groups up to now.Conclusion：On the treatment of small pulmonary nodule（the diameter ≤3cm） under VATS,segmentectomy,whereas the resection of less than three segments,can provide more benefits than lobectomy on preserving pulmonary function.