达芬奇机器人辅助胸腔镜肺叶切除术对肺癌患者心肺功能和生存质量的影响分析

Effect of da Vinci robot assisted thoracoscopic lobectomy on cardiopulmonary function and quality of life of patients with lung cancer

目的探讨达芬奇机器人辅助胸腔镜肺叶切除术对肺癌患者心肺功能与生存质量的影响。方法选取2019年1月至2019年9月于赤峰市医院行达芬奇机器人辅助胸腔镜肺叶切除术的23例肺癌患者纳入机器人组,并选取同期于该院接受胸腔镜肺叶切除术的30例肺癌患者纳入胸腔镜组。比较两组患者的围术期资料、手术前后心肺功能与生存质量。结果机器人组患者术中出血量显著少于胸腔镜组(P<0.05)。两组患者手术时间、淋巴结清扫组数和个数、并发症发生率及术后引流量、住院天数、左室射血分数(left ventricular ejection fraction,LVEF)、每搏量(stroke volume,SV)比较差异均无统计学意义(均P>0.05)。两组患者术后LVEF、SV、第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、用力肺活量(forced vital capacity,FVC)、最大自主通气量(maximal voluntary ventilation,MVV)及肺癌生存质量测定量表(functional assessment of cancer therapy-lung,FACT-L)中文版(V4.0)中FACT-G模块、肺癌特异模块评分和总分均显著高于本组术前(均P<0.05),左心室舒张末期内径(left ventricular end diastolic dimension,LVEDD)均显著小于本组术前(均P<0.05)。机器人组患者术后FEV1、FVC、MVV及FACT-L中文版(V4.0)中FACT-G模块评分和总分均显著高于同期胸腔镜组(均P<0.05)。结论达芬奇机器人辅助胸腔镜肺叶切除术能改善肺癌患者的肺功能,提高生存质量。

Objective To analyze the effect of da Vinci robot assisted thoracoscopic lobectomy on cardiopulmonary function and quality of life of patients with lung cancer.Method The twenty-three patients with lung cancer underwent da Vinci robot assisted thoracoscopic lobectomy from January 2019 to September 2019 in Chifeng City Hospital were enrolled for the study as robot group,and 30 patients with lung cancer underwent thoracoscopic lobectomy in that hospital during the same time were selected as thoracoscopic group.The perioperative data,cardiopulmonary function and quality of life before and after surgery were compared between the two groups.Result The intraoperative blood loss in robot group was significantly less than that of thoracoscopic group(P<0.05).There were no significant differences between the two groups in operation time,number of groups and number of lymph node dissection,complication rate,postoperative drainage volume,hospital day,left ventricular ejection fraction(LVEF)and stroke volume(SV)(all P>0.05).After surgery,the LVEF,SV,forced expiratory volume in one second(FEV1),forced vital capacity(FVC),maximal voluntary ventilation(MVV)and the score of functional assessment of cancer therapy-general(FACT-G)module,lung cancer specific module and total score of Chinese version of the functional assessment of cancer therapy-lung(FACT-L)(V4.0)were significantly higher than those before surgery(all P<0.05),while the left ventricular end diastolic dimension(LVEDD)was significantly lower than that before surgery(all P<0.05).After surgery,the FEV1,FVC,MVV and the score of FACT-G module and total score of FACT-L(V4.0)in robot group were significantly higher than those in thoracoscopy group(all P<0.05).Conclusion Da Vinci robot assisted thoracoscopic lobectomy can improve pulmonary function and the quality of life of lung cancer patients.