改良后外侧小切口术与开胸手术治疗肺癌比较

Comparison of Modified Lateral Small Incision Operation with Thoracotomy in Lung Cancer

目的 观察改良后外侧小切口术治疗肺癌的临床效果.方法 随机选取201 3年2月～ 2014年2月笔者医院诊治并行择期手术的84例肺癌患者,按照患者手术方法分为两组,对照组42例患者予以传统开胸术治疗,研究组42例患者予以改良后外侧小切口术治疗,分析两组患者术中、术后相关性指标变化及并发症情况.结果 研究组患者的术中开胸时间、切口长度、出血量及关胸时间均明显优于对照组,差异均具有统计学意义（P＜0.05）;研究组的术后插管时间、引流量、住院时间及疼痛评分均明显优于对照组,差异均具有统计学意义（P＜0.05）;另外,研究组肺感染、肩关节活动障碍及心律失常2例（4.76％）、4例（9.52％）、3例（7.14％）均明显少于对照组8例（19.05％）、12例（28.57％）、10例（23.81％）,差异具有统计学意义（P＜0.05）.结论 改良后外侧小切口术治疗肺癌的近期临床效果显著,患者术中切口较小,术后并发症发生率明显降低.

Objective To observe the clinical effects of modified lateral small incision operation in lung cancer. Methods Data （84 cases） were randomly selected from the lung cancer patients who received treatment and selective operation in our hospital from Feb- ruary 2013 to February 2014. According to the double blind method, they were divided into two groups. 42 cases as the control group were given the traditional thoracotomy; while the other 42 cases as the research group were given the modified lateral small incision operation. Then the relevant changes of intraoperative and postoperative indexes, and the incidence of complication in two groups were analyzed. Results Open time, incision length, blood loss and sternal closure time during surgery in the research group were clearly superior to that in the control group, with difference and statistical significance （P 〈 0. 05）. Moreover, intubation time, flow rate, length of stay and pain scores after operation in the research group were also superior to that in the control group; pulmonary infection and shoulder joint hypoac- tivity were with difference and statistical significance （P 〈 0.05）. Besides,cases of arrhythmia in the research group [2 cases（4.76% ）, 4 cases（9.52% ）, 3 cases（7.14% ） ] were respectively less than that in the control group [ 8 cases（ 19.05 % ）, 12 cases（28.57% ）, 10 cases（23.81% ） ], with clear difference and statistical significance （P 〈 0.05）. Conclusion Modified lateral small incision surgery in lung cancer has apparently clinical effects, with the small incision during operation and the lower incidence of complication after operation.