胸腔镜下肺叶切除治疗早期周围型肺癌的临床疗效及机体炎性反应观察

OBSERVATION ON THE CLINICAL THERAPEUTIC EFFECTS OF THORACOSCOPIC PULMONARY LOBECTOMY ON EARLY PERIPHERAL LUNG CANCER AND THE INFLAMMATORY REACTION OF THE BODY

目的探讨胸腔镜下肺叶切除治疗早期周围型肺癌的临床疗效及机体炎性反应,促进患者术后康复。方法选取符合标准的患者80例,随机分为观察组和对照组各40例,观察组应用胸腔镜下肺叶切除术,对照组应用传统开胸手术治疗,比较二组患者手术一般情况、术后并发症发生率及血清炎性因子的变化。结果二组患者手术时间相似(P>0.05),但观察组患者术中出血量、术后下床活动时间、胸腔引流管留置时间和术后住院时间等方面,均优于对照组,差异有统计学意义(P<0.05)。观察组患者术后并发症发生率12.50%,明显低于对照组的35.00%,差异有统计学意义(P<0.05)。二组患者术前血清中CRP、TNF-α、IL-6和IL-10水平比较,差异无统计学意义(P>0.05);术后3d,二组血清中CRP、TNF-α、IL-6和IL-10水平与术前比较,差异有统计学意义(P<0.05);但观察组升高幅度低于对照组,差异有统计学意义(P<0.05)。结论胸腔镜下肺叶切除治疗早期周围型肺癌,手术创伤小,术后并发症发生率低,机体炎性反应小,有利于患者术后康复,值得临床推广应用。

Objective To investigate the clinical therapeutic effects of thoracoscopic pulmonary lobectomy on early peripheral lung cancer and the inflammatory reaction of the body, and promote the postoperative rehabilitation of the patients. Methods Eighty patients meeting criteria were selected and randomly divided into observation group and control group, 40 patients each group. The observation group was treated with thoracoscopic pulmonary lobectomy, while the control group treated with traditional thoracotomy, and the general conditions, incidences of postoperative complications and changes in serum inflammatory factor in patients of the two groups were compared. Results The operation times of patients in two groups were similar （P〉0.05）, but the intraoperative blood loss, the number of days before postoperative out- of- bed activity, the number of days before extubation of intrathoracic drain tube and the number of days of postoperative hospitalization and so on for patients in the observation group were all better than those in the control group, and the differences were statistically significant （P〈0.05）. The incidence of the postoperative complications in the observation group was 12.50%, was significantly lower than that in the control group （35.00%） （P〈0.05）. The differences in preoperative serum CRP, TNF - α, IL - 6 and IL - 10 levels in the patients between the two groups were statistically insignificant （P〉0.05） ; when compared with those before the operations, the serum CRP, TNF- α, IL- 6 and IL- 10 levels in 3d after the operations in the patients of both groups significantly changed （P%0.05）, but the increasing extents in the observation group were lower than those in the control group（P〈0.05）. Conclusions Thoracoscopic pulmonary lobectomy in treatment of early peripheral lung cancer can cause a small operation wound, low incidence of postoperative complications and small inflammatory reaction of the body, is beneficial to the postoperative rehabilitation of the patients, and consequently is worthy of clinical application.