胸腔镜肺叶切除术治疗肺癌的临床效果观察

Efficacy of video-assisted thoracoscopic surgery in the treatment of lung cancer

目的：比较电视胸腔镜与传统开胸肺叶切除术治疗肺癌的临床疗效。方法选择77例肺癌患者作为研究对象，按患者意愿分为电视胸腔镜（VATS）肺叶切除术组43例和传统开胸（OT）肺叶切除术组34例，比较两组手术时间、术中出血量、术后胸管留置时间、住院时间及术后并发症发生率差异，术后1 d、术后3 d、术后5 d 进行疼痛 VAS 评分及术前、术后1 d、术后5 d 进行血清 CRP 检测。结果 VATS 组和 OT 组的手术时间、术后胸管留置时间、住院时间、术中出血量、术后并发症发生率分别为（134±52）min 和（167±45）min，（2．50±0．30）d 和（4．68±0．66）d，（4．77±0．54）d 和（7．20±0．68）d，103±26）mL 和（248±43）mL，11．63％和38．24％，差异均有统计学意义（t ＝3．563、3．725、9．621、3．402和χ^2＝7．504，均 P ＜0．05）。VATS组和 OT 组术后1 d、术后3 d VAS 评分分别为（6．22±0．82）分和（8．13±0．72）分、（4．46±0．48）分和（6．31±0．54）分，差异均有统计学意义（t ＝3．927、3．742，均 P ＜0．05）；VATS 组和 OT 组术后1 d、术后5 d 血清 CRP 水平分别为（38．32±9．59）μg／L 和（58．43±10．62）μg／L，（17．71±5．42）μg／L 和（36．65±8．25）μg／L，均较术前明显升高，但 VATS 组术后1 d、术后5 d 血清 CRP 水平均明显低于 OT 组，差异均有统计学意义（t ＝5．541、6．662，均 P ＜0．05）。结论胸腔镜肺叶切除术是一种创伤小、恢复快、术后疼痛轻的手术方式，降低患者术后急性期反应，可作为肺癌治疗的推荐治疗方式。

Objective To compare the efficacy of video -assisted thoracoscopic surgery and open -thoracot-omy in the treatment of lung cancer.Methods 77 patients with lung cancer were chose as study objects,all the patients were divided into two groups,43 cases of video -assisted thoracoscopic surgery group （VATS）and 34 cases of open -thoracotomy group （OT）The operative time,blood loss,postoperative chest tube indwelling time and hospi-tal stay and postoperative complication rate were compared.The VAS postoperative 1d,3d,5d after operation were calculated,and the serum CRP preoperative and postoperative 1d,postoperative 5d were detected.Results The oper-ative time,postoperative chest tube indwelling time,hospital stay,the blood loss,the complication rate in VATS group and OT group were （134 ±52）min and （167 ±45）min,（2.50 ±0.30）d and （4.68 ±0.66）d,（4.77 ±0.54）d and （7.20 ±0.68）d,103 ±26）mL and （248 ±43）mL,11.63% and 38.24%,the differences were statistically signifi-cant （t =3.563,3.725,9.621,3.402 and χ^2 =7.504,all P 〈0.05）.The VAS postoperative 1d,3d in VATS group and OT group were （6.22 ±0.82）score and （8.13 ±0.72）score,（4.46 ±0.48）score and （6.31 ±0.54）score,the differences were statistically significant,t =3.927,3.742,all P 〈0.05;the serum CRP after 1d,5d postoperative in VATS group and OT group were （38.32 ±9.59）μg/L and （58.43 ±10.62）μg/L,（17.71 ±5.42）μg/L and （36.65 ±8.25）μg/L,which were all higher than those of before surgery,but the serum CRP after 1d,5d postopera-tive in VATS group were lower than those of OT group,the differences were statistically significant（t =5.541,6.662, all P 〈0.05）.Conclusion VATS lobectomy is a trauma,quicker recovery,less postoperative pain surgical methods, and can reduce postoperative acute phase reaction,which should be recommended as a treatment for lung cancer.