胸腔镜与传统手术方法对非小细胞肺癌患者的临床疗效

A Clinical of Video-Assisted Thoracoscopic Surgery and Traditional Operation in Non-small Cell Lung Cancer Patients

目的:比较电视胸腔镜手术与传统手术方法对非小细胞肺癌治疗的临床效果。方法:选择2010年5月至2012年6月本院收治的非小细胞肺癌患者84例,随机分为VATS组和OT组,各42例,VATS组行全胸腔镜肺叶切除术;OT组行传统开胸肺叶切除术。比较两组患者手术时间、淋巴结清扫数、术中出血量、术后引流时间、住院天数、术后疼痛和并发症发生情况,观察并比较两组患者术后3d血清CRP、TNF-α、IL-6、IL-10水平。结果:VATS组术后引流时间、住院时间明显短于OT组(P<0.05);两组手术时间、淋巴结清扫数、术中出血量及并发症发生率比较无统计学差异(P>0.05);VATS组术后1d、3d疼痛评分明显低于OT组(P<0.05);VATS组术后3d血清CRP、TNF-α、IL-6、IL-10水平明显低于OT组(P<0.05)。结论:与传统手术相比,电视胸腔镜手术对患者创伤较小,患者术后炎症反应较低,痛苦较小,可作为非小细胞肺癌的推荐手术方式。

Objective： To compare the clinical effect of video-assisted thoracoscopic surgery and traditional operation method in non-small cell lung cancer.Methods： 84 patients with non small cell lung cancer who were treated in our hospital from May 2010 to June 2012 were selected and randomly divided into VATS group and OT group,42 cases in each group.Patients in the VATS group were underwent video-assisted thoracoscopic surgery,while patients in the OT group were underwent thoracotomy combined with lobectomy.The resected lymph nodes,operation time,intraoperative bleeding volume,postoperative drainage time,hospitalization,postoperative pain and complications of patients were compared between two groups,and the postoperative 3 d serum CRP,TNF-α,IL-6 and IL-10 levels were detected.Results： The drainage time and hospitalization of patients in the VATS group was significantly shorter than those of the OT group（P0.05）;There was no statistically significant difference about the operation time,intraoperative lymph node yield,the blood loss and the incidence of complications between two groups（P0.05）;The pain of patients in the VATS group was significantly lower than that of the OT group after treating for one day and three days（P0.05）;The CRP,TNF-α,IL-6,IL-10 levels of patients in the VATS group were significantly lower than those in the OT group after three days（P0.05）.Conclusion： Compared with the traditional operation,small video-assisted thoracoscopic operation on patients can be used as a non small cell lung cancer with the advantages of mix trauma,less postoperative inflammatory reaction and less pain.