胸腔镜手术治疗肺癌的疗效及其对患者术后应激反应的影响

Clinical effect of thoracoscopic surgery for patients with lung cancer and the influence on the postoperative stress reaction

目的探讨胸腔镜手术治疗肺癌的临床效果及其对患者术后应激反应的影响,为临床治疗提供参考依据。方法选取2014年12月至2016年1月于我院胸外科收治的早期肺癌患者102例,根据治疗方法不同将其分为观察组(n=51)与对照组(n=51),对照组采取传统开胸手术治疗,观察组采取电视胸腔镜手术治疗。术后比较两组患者的治疗临床效果及应激反应相关指标。结果在术后出血量、术后引流量、术后住院时间等方面,观察组与对照组比较均明显降低,差异均具有统计学意义(P<0.05);观察组患者的治疗总有效率为88.2%,与对照组的70.6%比较明显升高,差异具有统计学意义(P<0.05);在应激反应指标(皮质醇、前列腺素E2及P物质)方面,观察组患者术后1 d、3 d、7 d的水平与对照组比较均明显降低,差异具有统计学意义(P<0.05);在炎性反应指标(C反应蛋白、白细胞介素-6、肿瘤坏死因子-α)方面,观察组术后1 d、3 d、7 d的水平与对照组比较均明显降低,差异均具有统计学意义(P<0.05)。结论对早期肺癌患者进行电视胸腔镜肺叶切除手术具有更优的临床治疗效果,其具有创伤小、恢复快、治疗效果可靠等优势,且对术后应激反应的影响较低,值得临床推广应用。

Objective To investigate the effect of thoracoscopic surgery in the treatment of patients with lung cancer and influence on the postoperative stress reaction, and provide a reference basis for clinical treatment.Methods A total of 102 patients with early lung cancer were selected in our hospital from December 2014 to January2016. According to different treatment, the patients were divided into observation group（n=51） and control group（n=51）. The control group was treated with traditional thoracotomy, and the observation group was treated with video-assisted thoracoscopic surgery. The clinical effect and stress reaction-related indicators of the two groups were observed after treatment. Results The observation group was significantly lower than the control group in the bleeding, postoperative drainage and postoperative hospital stay, etc. after surgery（P〈0.05）. In clinical effectiveness of the treatment, total effective rate of the observation group was 88.2%, which was significantly higher than that of the control group（70.6%）, and the difference was statistically significant（P〈0.05）. In stress response indexes（cortisol, prostaglandin E2 and P substance）, the postoperative levels of 1 d, 3 d and 7 d in the observation group were significantly lower than those in the control group. The difference was statistically significant（P〈0.05）. In inflammatory reaction indexes（C-reactive protein, interleukin 6 and tumor necrosis factor-α）, the postoperative levels of 1 d, 3 d and 7 d in the observation group were significantly lower than those in the control group（P〈0.05）. Conclusion Video-assisted thoracoscopic surgery in patients with early lung cancer has better clinical effect, with little trauma, quick recovery, reliable therapeutic effect, and less impact on the postoperative stress reaction, which is worthy of clinical popularization and application.