袖状与楔形支气管切除术在支气管肺癌治疗中的临床对照研究

A controlled clinical trial between bronchial sleeve resection and bronchial wedge resection for the treatment of bronchopulmonary carcinoma

目的：观察对比分析袖状切除术与楔形切除术在支气管肺癌治疗中的效果。方法选取100例支气管肺癌患者作为研究对象，选用随机表格法，将所有患者分为观察组（50例，给予袖状切除术治疗），对照组（50例，给予楔形切除术治疗），分别在术后进行相应的辅助治疗，治疗结束后随访3年。结果术后近期疗效比较中，观察组吻合口瘘发生率与病死率分别为4％、6％，对照组为6％、8％，两组差异均无统计学意义（χ^2=0．00、0．00，均P＞0．05）；观察组支气管残端癌细胞阳性率为4％，明显低于对照组的16％（χ^2=4．00，P＜0．05）。观察组在随访期内的吻合口瘢痕组织增生率与复发率分别为2％、2％，均低于对照组的16％、18％（χ^2=4．40、7．11，均P＜0．05）。观察组1、3年生存率分别为92％、64％，均显著高于对照组的62％、42％（χ^2=12．70、4．86，均P＜0．05）。结论采取袖状切除术治疗支气管肺癌，能够有效控制患者的支气管残端癌细胞阳性率，抑制吻合口瘢痕组织增生，减少复发率，并且远期疗效非常理想，值得在临床中推广应用。

Objective To make contrast analysis of sleeve lobectomy and wedge resection in lung cancer treatment by observing the clinical curative effect.Methods 100 patients with lung cancer using random table method, all the patients were divided into the observation group （ 50 cases, treated with sleeve resection ） , control group （50 cases,treated with wedge resection）,follow-up after treatment lasted respectively for 3 years.Results In the two groups,anastomotic fistula incidence and mortality rates of the observation group were 4%,6%;6% and 8% in the control group,there were no statistical difference （χ^2=0.00,0.00,all P〉0.05）;the positive rate of stump cancer cell bronchial in the observation group was 4%,it was obviously less than 16% in the control group,and the differ-ence was obvious （χ^2=4.00,P〈0.05） .The anastomotic scar tissue hyperplasia and recurrence rate of the observa-tion group during the follow-up period were 2%,2%;which were lower than 16%,18% of the control group （χ^2=4.40,7.11,all P〈0.05）.The 1,3 year survival rates of the observation group were 92%,64%,which were higher than 62%and 42%of the control group （χ^2=12.70,4.86,all P〈0.05）.Conclusion Taking sleeve resection for bronchogenic carcinoma can effectively control the positive rate of bronchial stump with cancer cells,inhibit anasto-motic scar tissue hyperplasia,reduce the recurrence rate,and the curative effect is very good,which is worth of clinical application.