胸腔镜肺癌手术治疗对患者术后应激反应的影响观察

Effect of surgical treatment of patients with lung cancer on postoperative stress reaction

目的研究分析电视胸腔镜肺叶切除手术治疗非小细胞肺癌(NSCLC)患者术后应激反应相关指标的影响作用。方法采取回顾性分析方法对海南省农垦总医院胸外科收治的92例手术切除肺叶患者的手术资料进行统计分析,其中采用最新电视胸腔镜手术治疗39例(胸腔镜组)、传统开胸手术治疗53例(传统组),比较两组患者手术应激相关指标的差异。结果胸腔镜组的手术时间、术中出血量、术后引流量、胸腔引流管时间、清扫淋巴结数目、住院时间与传统组比较,差异均无统计学意义(P>0.05)。术后第1、3、7天胸腔镜组的皮质醇、生长激素、前列腺素E2、P物质水平显著低于传统组(P<0.05)。术后第1、3、7天胸腔镜组的C反应蛋白、白细胞介素-6、肿瘤坏死因子-ɑ水平显著低于传统组(P<0.05)。结论电视胸腔镜肺叶切除手术较传统手术治疗NSCLC具有手术效果可靠、创伤小、恢复快、术后应激反应水平低等优点。

Objective Research and analysis of video-assisted thoracoscopic lung resection for the treatment of non-small cell lung cancer effect of postoperative stress response related indicators. Methods Take operation data were retrospectively analyzed in 92 cases of operation method in our hospital were admitted to Department of thoracic surgery lobectomy patients for statistical analysis, 39 cases （53 cases ） were treated by using the latest video assisted thoracic surgery （Group） and conventional thoracotomy, to comparison difference of two groups of patients with surgical stress related indicators. Results There was no significant difference in the operation time, bleeding volume, postoperative drainage volume, postoperative drainage volume, time of drainage tube, the number of lymph nodes, length of hospital stay and the traditional group （P 〉 0.05 ）. The levels of COR, GH, PGE2 and P in patients with 1 , 3 , and 7 d were significantly lower than those in the traditional group （ P 〈 0.05 ）. After the 1 , 3 , 7 d thoracoscopic group of patients with CRP, IL-6, TNF-a level was significantly lower than the traditional group of patients （P 〈 0.05 ）. Conclusions Video- assisted thoracoscopie lung resection surgery compared to traditional surgery in the treatment of non-small cell lung cancer with reliable in operation, small trauma, rapid recovery, postoperative stress reaction and low levels of advantages.