探讨先清扫淋巴结在胸腔镜肺癌手术中的可行性及优越性

The Feasibility and Superiority of the First Lymph Dissection in Macroscopic Lung Cancer Surgery

目的:分析胸腔镜肺癌术中先清扫淋巴结治疗的应用价值,以总结更为有效的胸腔镜肺癌手术方案。方法:将60例拟应用胸腔镜进行肺癌手术治疗的患者随机分A组及B组,每组30例。A组术中先行肿瘤切除后行淋巴结清扫,B组术中先行淋巴结清扫后行肿瘤切除。对比两组术中及术后情况。结果:两组术中出血量、手术时间、淋巴结清扫站数、淋巴结清扫数及术后疼痛评分比较差异均无统计学意义(P>0.05),但B组术后引流量明显少于A组,术后引流时间明显短于A组(P<0.05)。两组治疗前生活质量评分中躯体功能、角色功能、认知功能、情绪功能及社会功能比较差异均无统计学意义(P>0.05),接受术后4周时,两组以上评分均得到有效改善,而B组明显优于A组(P<0.05)。此外,两组术后并发症发生率比较差异无统计学意义(P>0.05)。结论:胸腔镜肺癌术中先于清扫淋巴结可在不降低手术治疗效果的同时,有效地改善患者的术后恢复情况。

Objective： To analyze the dissection value of first macroscopic lung cancer surgery treatment of lymph node,to summarize more effective macroscopic lung surgery program.Method：60 patients were to be applied macroscopic lung cancer surgery were randomly divided into group A and group B, 30 cases in each group.Group A in advance carried tumor excision, then cleaned lymph node, group B in advance cleaned lymph node then carried tumor excision.The cooperativeness and postoperative conditions of two groups were compared.Result：The blood loss, operating time, the number of stations lymph node dissection, the number of lymph node dissection and postoperative pain scores of the two groups were no significant differences （P〉0.05）, but postoperative drainage of the group B was significantly less than the group A, postoperative drainage time was significantly shorter the group A （P〈0.05）.Before treatment, while the quality of life scores in physical function, role function, cognitive function, emotional function and social function relatively of the two groups were no significant differences （P〉0.05）, while treatment after 4 weeks, the scores of the two groups had been effectively improved, while group B were significantly better than the group A （P〈0.05）. In addition, the incidence of postoperative complications of the two groups was no significant difference （P〉0.05）. Conclusion：Macroscopic lung cancer surgery in the lymph nodes before recovery can not reduce surgical treatment at the same time, effectively improve the postoperative patient.