袖状切除术和全肺切除术治疗非小细胞肺癌的对照研究

Control study of sleeve lobectomy and pneumonectomy in the treatment of non-small cell lung cancer

目的 探讨袖状切除术和全肺切除术治疗非小细胞肺癌的临床疗效.方法 将130例非小细胞肺癌患者随机分为两组,每组65例.观察组给予袖状切除术,对照组给予全肺切除术.对两组患者手术前后肺功能[第一秒用力呼气量（FEV1）、用力肺活量（FVC）、自测呼气峰值流速（PEF）]进行测定,并对术后并发症情况进行观察.术后随访5年,对患者生存情况进行观察.结果 术后,两组FEV1、FVC、PEF水平显著降低,观察组FEV1、FVC、PEF水平显著高于对照组（P＜0.05）.观察组并发症发生率为12.3％,显著低于对照组的27.7％.观察组术后1、3、5年的生存率为81.5％、61.5％、47.7％,均显著高于对照组的64.6％、41.5％、27.7％.结论 相比于全肺切除术,袖状切除术可有效治疗非小细胞肺癌,具有肺功能损伤小、并发症率低、生存率高的优点.

Objective To investigate the clinical efficacy of sleeve lobectomy and pneumonectomy in the treatment of non-small cell lung cancer （NSCLC）.Methods 130 cases of NSCLC were randomly divided into two groups,65 cases in each group.Patients in observation group were given sleeve lobectomy,while patients in control group were given pneumonectomy.Before and after surgery,lung function [forced expiratory volume in one second （FEV1）,forced vital capacity （FVC）,peak expiratory flow rate on self-test （PEF）] of two groups were measured,and postoperative complications of two groups were observed.All patients were followed up for 5 years,the survival rate of two groups were observed.Results After surgery,the levels of FEV1,FVC,PEF of two groups significantly reduced,and the levels of FEV1,FVC,PEF of observation group were significantly higher than those of control group （P〈0.05）.The complication rate of observation group was 12.3%,which was significantly lower than 27.7% of control group （P〈0.05）.The 1,3,5-year survival rate of observation group were 81.5%,61.5% and 47.7%,which were significantly higher than 64.6%,41.5%,27.7% of control group （P〈0.05）.Conclusion Compared to pneumonectomy,sleeve lobectomy can effectively treat NSCLC,with advantages of small pulmonary injury,low complication rate,and high survival rate.