单孔胸腔镜下肺叶切除术治疗肺癌临床治疗体会

Experience of Single-port Video-assisted Thoracoscopic Pulmonary Lobectomy in Treatment of Lung Cancer

目的分析单孔胸腔镜下肺叶切除术治疗肺癌的临床体会。方法选取2016年8月—2017年8月该院收治的100例肺癌患者作为研究对象,将患者分为对照组(50)例、观察组(50)例,给予对照组患者采用三孔胸腔镜肺叶切除术治疗,观察组患者采用单孔胸腔镜手术展开肺叶切除。比较两组患者手术时间、术中出血量、淋巴结清扫数、胸腔引流管留置时间、住院时间、术后并发症等情况。结果对照组患者手术时间、术中出血量、淋巴结清扫数目分别为:(141.67±39.18)min、(110.75±39.19)mL、(12.38±0.57)个,观察组患者手术时间、术中出血量、淋巴结清扫数目分别为:(141.20±40.19)min、(109.00±48.76)mL、(12.45±0.60)个,两组差异无统计学意义(t=1.752、2.231、0.357,P>0.05);对照组腔引流管留置时间、术后住院时间、VAS评分分别为:(4.96±1.08)d、(12.61±2.18)d、(6.42±1.32)分,观察组腔引流管留置时间、术后住院时间、VAS评分分别为(2.35±0.27)d、(7.12±2.21)d、(3.72±1.27)分,因此,观察组患者胸腔引流管留置时间、术后住院时间、VAS评分均优于对照组,差异有统计学意义(t=13.452、10.265、9.224,P<0.05)。对照组有2例肺不张、1例肺部感染,并发症发生率为20.0%,观察组有1例肺不张,0例肺部感染,并发症发生率为6.7%,因此,观察组患者术后并发症发生率低于对照组,差异有统计学意义(χ~2=4.236,P<0.05)。结论对肺癌患者实施单孔胸腔镜下肺叶切除术,对减少患者术中出血量、减轻患者疼痛等发挥重要作用,有效促进患者疾病康复,该治疗方法值得在临床中推广应用。

Objective To analyze the clinical experience of single-port video-assisted thoracoscopic pulmonary lobectomy in treatment of lung cancer. Methods 100 cases of patients with lung cancer patients admitted and treated in our hospital from August 2016 to August 2017 were selected and divided into two groups with 50 cases in each, the control group were treated with three-port thoracoscopic pulmonary lobectomy, while the observation group were treated with single-port video-assisted thoracoscopic pulmonary lobectomy, and the operation time, intraoperative bleeding amount,lymph node dissection number, retention time of thoracic drainage tube, length of stay and postoperative complications were compared between the two groups. Results The operation time, intraoperative bleeding amount and lymph node dissection number in the control group and in the observation group were respectively（141.67 ±39.18）min,（110.75 ±39.19）mL,（12.38 ±0.57） VS（141.20 ±40.19）min,（109.00 ±48.76）mL,（12.45 ±0.60）, and the differences between groups were not statistically significant（t=1.752, 2.231,0.357, P〉0.05）; and retention time of thoracic drainage tube, length of stay after surgery and VAS score in the control group and in the observation group were respectively（4.96 ±1.08）d,（12.61±2.18）d,（6.42±1.32）points VS（2.35±0.27）d,（7.12±2.21）d,（3.72±1.27）points, therefore, the indicators in the observation group were better than those in the control group, and the differences were statistically significant（t=13.452,10.265, 9.224, P〈0.05）, and the incidence rate of complications in the observation group was lower than that in the control group（6.7% vs 20.0%）（1 case with atelectasis and 0 case with lung infection） and（2 cases with atelectasis and1 case with lung infection）, and the difference was statistically significant（χ^2=4.236, P〈0.05）. Conclusion The implementation of single-port video-assisted thoracoscopic pulmonary lobectomy in treatment of lung cancer patients is of important significance to reducing the intraoperative bleeding amount and relieving the pains of patients, which can effectively promote the diseases recovery of patients, and it is worth clinical promotion and application.