胸腔镜肺癌根治术对高龄患者肺功能的影响

The Influence of Pulmonary Function by Thoracoscopic Radical Lobectomy on Elderly Patient with Lung Cancer

目的:探讨全胸腔镜肺叶切除术与开胸肺叶切除术这两种手术方式对高龄非小细胞肺癌患者肺功能的影响。方法:收集2012年5月-2015年10月来本科室就诊的129例高龄右上叶非小细胞肺癌患者为研究对象,将其均分为两组,腔镜组的68例患者实行胸腔镜下右上肺叶切除术,开胸组的61例患者实行开胸右上肺叶切除术。比较两组患者的手术情况,手术前后患者的VC、FEV_1、MVV等肺功能指标,手术后的并发症情况。结果:腔镜组的出血量、引流量、镇痛时间和术后住院时间指标均优于开胸组(P<0.05);手术前两组患者的VC、FEV_1、MVV等肺功能指标比较,差异均无统计学意义(P>0.05),手术后两组患者的肺功能各指标下降值比较,差异均有统计学意义(P<0.05);腔镜组患者术后伤口感染、心律失常、皮下气肿、肺炎、肺不张等并发症的发生率均低于开胸组(P<0.05)。结论:使用全胸腔镜下肺叶切除较之开胸肺叶切除可以减少手术出血量、引流量,减轻疼痛,缩短住院时间,肺功能的损害小,并发症发生率低,更适于治疗高龄非小细胞肺癌。

Objective：To explore the effect of thoracoscopic lobectomy and open thoracotomy lobectomy of the two surgical methods of pulmonary function in patients with non-small cell lung cancer in the elderly. Method：129 cases of elderly non-small cell lung cancer in our hospital from May 2012 to October 2015 were selected,they were divided into two groups,68 patients in laparoscopic group were implemented complete thoracoscopic lobectomy,61 cases in the thoracotomy group were implemented thoracotomy with lobectomy. The operation situations,VC,FEV1,MVV and other pulmonary function indexes of patients before and after operation,and the complications after operation were observed.Result：The blood loss,drainage,duration of analgesia and postoperative hospitalization time in laparoscopic group were better than those of thoracotomy group （P〈0.05）.Before the operation the VC,FEV1,MVV and other lung function index of two group patients had no statistical significance（P〉0.05）,and after surgery the difference of decreased pulmony index between two groups has statistical significance（P〈0.05）.The wound infection,postoperative endoscopic arrhythmia,subcutaneous emphysema,pneumonia,atelectasis and incidence of complications in laparoscopic group were lower than those in thoracotomy group（P〈0.05）.Conclusion：Thoracoscopic lobectomy compared with lobectomy can reduce the amount of hemorrhage,drainage, pain,shorten the hospitalization time,lung function damage is small,low complication occurance,more suitable for the treatment of advanced non-small cell lung cancer.