全胸腔镜肺叶切除术治疗早期非小细胞肺癌患者的预后分析

Prognosis Analysis of Patients with Non-small Cell Lung Cancer in Early Stage after Video-assisted Thoracoscopic Lobectomy

目的:探讨全胸腔镜肺叶切除术治疗早期非小细胞肺癌(NSCLC)患者的疗效及预后状况。方法:选择2010年6月至2013年6月我院收治的早期NSCLC患者80例作为研究对象,随机分为对照组(n=40)和实验组(n=40)。对照组患者行常规开胸肺叶切除术,实验组患者行全胸腔镜肺叶切除术,所有患者于术后视具体情况给予化疗或放疗。记录两组患者术中及术后临床相关指标,术后并发症发生率,术后随访3年,比较两组患者3年生存率,并分析全胸腔镜肺叶切除术后患者预后影响因素。结果:实验组患者手术时间、术中出血量、胸腔引流时间及住院时间均明显低于对照组(P<0.05)。实验组患者术后并发症发生率、术后3年生存率分别为12.50%、57.50%,与对照组的17.50%、50.00%相比,差异均无统计学意义(P>0.05)。Cox多因素分析结果显示,肿瘤直径和术后是否放化疗是影响全胸腔镜肺叶切除术后患者预后的危险因素(P<0.05)。结论:全胸腔镜肺叶切除术治疗早期NSCLC患者具有微创、安全及远期生存率较高的特点,术后辅以放化疗能够延长患者的生存率。

Objective： To explore the effect and prognosis of patients with non small cell lung cancer（NSCLC）in early stage after video-assisted thoracoscopic lobectomy. Methods： A total of 80 cases of NSCLC patients in early stage admitted to our hospital from June 2010 to June 2013 were selected as the research objects, who were randomly divided into control group（n=40）and experiment group（n=40）. The control group was underwent conventional open chest operation, while the experiment group was received video-assisted thoracoscopic lobectomy, all patients were treated with chemotherapy or radiotherapy after surgery in needed. Recorded the intraoperative and postoperative clinical indicators, incidence rates of postoperative complications in two groups, followed up for 3 years, and compared the 3 years survival rate, finally, analyzed the risk factors affecting the prognosis in patients after video-assisted thoracoscopic lobectomy.Results： The surgery time, intraoperative blood loss,chest drainage time and length of stay of the experiment group were significantly less than that of the control group（P〈0.05）. The total incidence rate of postoperative complications and 3 years survival rate in experiment group respectively were 12.50%, 57.50%, which had no statistically significant differences from 17.50%, 50.00% in control group respectively（P〉0.05）. COX multivariate factors analysis showed that the tumor diameter and with or without postoperative radiotherapy and chemotherapy were the risk factors influencing the prognosis in patients after video-assisted thoracoscopic lobectomy（P〈0.05）. Conclusion： Applying video-assisted thoracoscopic lobectomy has the advantages of minimally invasive, safe and high long-term survival rate when treating the patients with NSCLC in early stage, after which combining radiotherapy and chemotherapy can prolong the survival rate of patients.