单孔胸腔镜肺癌根治术对老年肺癌患者免疫功能及生活质量的影响

Effect of single-port thoracoscopic radical resection on immune function and quality of life in elderly patients with lung cancer

目的探讨单孔胸腔镜肺癌根治术对老年肺癌患者免疫功能及生活质量的影响。方法选取该院近5年收治的老年肺癌患者60例,采用随机数字表法分为对照组及观察组,各30例。对照组给予常规三孔胸腔镜肺癌根治术,观察组给予单孔胸腔镜肺癌根治术,比较两组患者手术、疼痛、免疫功能相关指标及生活质量评分。结果观察组患者术中出血量、引流管留置时间和术后24 h引流量均显著少于对照组,差异有统计学意义(P<0.05);术后24 h,两组患者的去甲肾上腺素(NE)、5-羟色胺(5-HT)和多巴胺(DA)水平均显著升高,但观察组显著低于对照组,差异有统计学意义(P<0.05);术后3 d,观察组CD3^+、CD4^+和CD4^+/CD8^+水平下降不明显,但与对照组比较,差异有统计学意义(P<0.05);术后3个月,观察组患者的功能状态、情感状态和总分均显著高于对照组,差异有统计学意义(P<0.05)。结论采用单孔胸腔镜肺癌根治术在保证手术效果的情况下,可较少疼痛,对患者的免疫功能影响较小,且可提高患者的生活质量,更适合老年患者。

Objective To investigate the effect of single-port thoracoscopic radical lung cancer on immune function and quality of life in elderly patients with lung cancer.Methods A total of 60 cases of elderly patients with lung cancer admitted to our hospital were divided into the control group and the observation group according to random number table method,30 cases in each group.The control group were treated with conventional three-hole thoracoscopic radical resection of lung cancer,and the observation group were treated with single-hole thoracoscopic radical resection of lung cancer.The indexes related to surgery,pain,immune function and quality of life were compared between the two groups.Results The intraoperative blood loss,indwelling time of drainage tube and drainage volume 24 h after surgery in the observation group were significantly less than those in the control group(P<0.05).Twenty-four hours after surgery,the levels of NE,5-HT and DA in both groups were significantly increased,but their levels in the observation group were significantly lower than those in the control group(P<0.05).Three days after surgery,the levels of CD3^+,CD4^+and CD4^+/CD8^+in the observation group were not significantly decreased,their levels in the control group were significantly decreased,and there were statistically significant differences between the two groups(P<0.05).Three months after surgery,the functional status,emotional status and total score of quality of life in the observation group were significantly higher than those in the control group(P<0.05).Conclusion The use of single-hole thoracoscopic radical resection of lung cancer can ensure the operation effect and reduce pain,have less impact on the immune function of patients,and improve the quality of life of patients,which is more suitable for elderly patients.