全胸腔镜与后外侧开胸手术对非小细胞肺癌治疗效果研究

Thoracoscopic surgery versus posterolaterai thoracotomy for non-small cell lung cancer

目的探讨分析非小细胞肺癌患者采用全胸腔镜与后外侧开胸手术的治疗效果，并比较两种手术方式对患者机体免疫功能及炎症因子的影响。方法选取2013年12月至2015年11月收住本院的非小细胞肺癌患者38例列为观察组，均采取全胸腔镜手术治疗；同期人院患者40例为对照组，均采取后外侧开胸手术治疗。观察两组患者手术治疗效果，并分别在术前及术后3d检测两组患者可溶性白介素2受体（IL-2R）、白细胞介素-6（IL-6）、淀粉样蛋白A（SAA）、C-反应蛋白（CRP）及CD4＋、CD8＋、CD4＋／CD8＋等炎症因子和免疫细胞指标变化。结果观察组患者手术时间为（138．3±21．6）min、术中出血量为（311．5±48．4）ml、输血量为（147．3±30．4）ml，对照组分别为（227．7±28．5）min、（417．4±56．3）ml、（204．2±38．8）ml；观察组上述指标均优于对照组，差异均有统计学意义（均P〈0．05）。观察组IL-2R、IL-6、SAA、CRP及CD4＋、CD8＋、CD4＋／CD8＋等炎症因子和免疫学指标变化幅度均低于对照组，差异均有统计学意义（均P〈0．05）。结论对于早期非小细胞肺癌，全胸腔镜手术创伤较小，效果优良，且对机体免疫功能损害较为轻微，具有较高的应用价值。

Objective To investigate the effects of thoracoscopic surgery versus posterolateral thoracotomy for patients with non-small cell lung cancer. Methods 38 patients with non-small cell lung cancer treated at our hospital from December, 2013 to November, 2015 were selected as an observation group and all treated with thoracoscopic surgery. And 40 patients treated at our hospital during the same period were selected as a control group and treated with posterolateral thoracotomy. The clinical efficacy, IL-2R, IL-6, SAA, CRP, and CD4＋, CD8＋ , CD4＋/CD8＋ and other inflammatory factors and immune cell indexes were observed and compared. Results The operation time, the intra-operative bleeding volume, and blood transfusion volume were （ 138.3±21.6 ） min, （ 311.5± 48.4 ） ml,and （ 147.3±30.4 ） ml in the observation group and were （ 227.7±28.5 ） min, （ 417.4±56.3 ） ml, and （ 204.2±38.8 ） ml in the control group, respectively, with statistical differences （ P 〈 0.05 ） . The IL-2R, IL-6, SAA, CRP, CD4＋, CD8＋, CD4＋/CD8＋ and other inflammatory factors and immune index changes were lower in the observation group than in the control group （ P 〈 0.05 ） . Conclusions Thoracoscopic surgery for early non-small cell lung cancer is minimally invasive and effective and has mild damage to the immune function of the body, so it is of high application value.