胸腔镜下肺叶切除术在治疗肺癌中的临床应用

Clinical application of thoracoscopic lobectomy in the treatment of lung cancer

目的研究胸腔镜下肺叶切除术在治疗肺癌中的临床应用价值。方法 64例肺癌患者作为研究对象,随机分为胸腔镜组(观察组)和传统开胸组(对照组),各32例。观察两组患者的手术时间、术中出血量、清扫淋巴结数目、胸腔引流管留置时间、术后并发症、术后住院时间及1年无瘤生存率,采用视觉模拟评分法(VAS)评价术后切口疼痛情况。结果两组患者手术均获得成功。观察组术中出血量、胸腔引流管留置时间、术后住院时间、术后VAS评分均优于对照组,差异有统计学意义(P<0.05)。两组手术时间、术中淋巴结清扫数目比较,差异无统计学意义(P>0.05)。观察组与对照组1年无瘤生存率分别为96.88%、93.75%,比较差异无统计学意义(P>0.05)。观察组并发症发生率为12.50%,明显低于对照组的34.38%,差异有统计学意义(P<0.05)。结论胸腔镜下肺叶切除术治疗肺癌具有传统开胸手术所没有的独特优势,具有创伤小、出血量少、住院时间短、疼痛轻等优点,是一种安全、有效、微创的肺癌治疗方法 ,值得临床推广应用。

Objective To study the clinical application value of thoracoscopic lobectomy in the treatment of lung cancer. Methods A total of 64 lung cancer patients as study subjects were randomly divided into thoraeoscopic group （observation group） and traditional horacotomy group （control group）, with 32 cases in each group. Observation were made on operation time, intraoperative bleeding volume, number of lymph node dissection, thoracic drainage tube indwelling time, postoperative complications, postoperative hospitalization time and 1 year disease-free survival rate between two groups. Visual analogue score （VAS） was used to evaluate postoperative incision pain situation. Results Surgery was successful in both groups. The observation group had better intraoperative bleeding volume, thoracic drainage tube indwelling time, postoperative hospitalization time and postoperative VAS score than the control group, and their difference was statistically significant （P〈0.05）. Both groups had no statistically significant difference in operation time and number of lymph node dissection （/9〉0.05）. The observation group and control group had no statistically significant difference in 1 year disease-free survival rate respectively as 96.88% and 93.75% （P〉O.05）. The observation group had obviously lower incidence of complications as 12.50% than 34.38% in the control group, and the difference was statistically significant （P〈0.05）. Conclusion Thoracoscopic lobectomy for lung cancer has the unique advantage of less trauma, less bleeding, shorter hospitalization time, less pain, comparing with traditional thoracotomy. It is a safe, effective and minimally invasive treatment method for lung cancer, and is worthy of clinical promotion and application.