全胸腔镜手术在非小细胞肺癌患者中的临床疗效及安全性

Analysis of the clinical efficacy and safety of complete video-assisted thoracic surgery in non-small cell lung cancer patients

目的:探析全胸腔镜手术(complete video-assisted thoracic surgery,CVATS)在非小细胞肺癌(non-small cell lung cancer,NSCLC)患者治疗中的临床疗效及安全性。方法:分析2015年2月至2018年2月在武威市人民医院接受诊断治疗的110例NSCLC患者的临床资料。根据手术方式的不同,将入选者分成开胸组(35例)、CVATS组(40例)和胸腔镜辅助小切口手术(video-assisted mini-thoracotomy,VAMT)组(35例)。比较三组患者的基线资料、手术情况及术后并发症情况。结果:三组患者的基线资料差异无统计学意义(P>0.05)。CVATS组患者的术中出血量、引流管留置时间、术后住院时间及术后引流量均明显低于VAMT组和开胸组,且VAMT组术中出血量、引流管留置时间、术后住院时间及术后引流量均明显低于开胸组(P<0.05)。CVATS组患者的并发症发生率(2.5%)明显低于开胸组(17.1%;χ^2=4.730,P=0.03),CVATS组患者的并发症发生率低于VAMT组,VAMT组患者的并发症发生率低于开胸组,但差异均无统计学意义(χ^2=2.392,P=0.12;χ^2=0.467,P=0.49)。CVATS组、VAMT组患者的心理状态、护理评价、下床活动能力评分均明显高于开胸组,住院费用明显低于开胸组(P<0.05);CVATS组、VAMT组患者的心理状态、护理评价评分、下床活动能力及住院费用比较差异无统计学意义(P>0.05)。结论:CVATS手术在NSCLC患者中的临床疗效及安全性均较突出,值得推广。

Objective:To analyze the clinical efficacy and safety of complete video-assisted thoracic surgery (CVATS) in nonsmall cell lung cancer (NSCLC) patients.Methods:Clinical data of 50 patients with NSCLC received treatment at our hospital from February,2015 to February,2018 was retrospectively analyzed.Patients included were divided into three groups according to the operative methods:a traditional thoracotomy group (35 cases),a CVATS group (40 cases),and a video-assisted mini-thoracotomy (VAMT) group (35 cases).The general information, the operative condition,and postoperative complications in three groups were compared.Results:The general information in three groups had no statistical difference (P>0.05).The intraoperative bleeding volume,the indwelling time of drainage tube,the postoperative hospital stay and the postoperative drainage volume in the CVATS group were significantly lower than those in the VAMT group and the traditional thoracotomy group, and the intraoperative bleeding volume,the indwelling time of drainage tube,the postoperative hospital stay and the postoperative drainage volume in the VAMT group were significantly lower than those in the traditional thoracotomy group (P<0.05).The postoperative complications rate in CVATS group (2.5%) was significantly lower than that in the traditional thoracotomy group (17.1%;χ^2=4.730,P=0.03),and the postoperative complications rate in the CVATS group was lower than that in the VAMT group,and the postoperative complications rate in the VAMT group was lower than that in the traditional thoracotomy group (χ^2=2.392, P=0.12;χ^2=0.467,P=0.49).The scores of the psychological state,the nursing evaluation,the ambulation ability in the CVATS group and the VAMT group were significantly higher than those in the traditional thoracotomy group, and the hospitalization expenses in the CVATS group and the VAMT group was significantly lower than that in the traditional thoracotomy group (P<0.05).The scores of the psychological state,the nursing evaluation,the ambulation ability in the CVATS group and the VAMT had no statistical difference (P>0.05).Conclusion:The clinical efficacy and safety of CVATS in the NSCLC patients is significant,which is worth promoting.