肺癌根治性袖状切除术对非小细胞肺癌机体应激创伤反应、肺功能及生活质量的影响

Effects of radical sleeve resection of lung cancer on stress response,pulmonary function and quality of life in non-small cell lung cancer

目的:探讨肺癌根治性袖状切除术对非小细胞肺癌机体应激创伤反应、肺功能及生活质量的影响。方法:选取我院2014年2月至2017年12月期间收治的非小细胞肺癌患者96例,采用随机数字表法,将患者分为对照组和观察组。对照组接受全肺切除术,观察组行袖状切除术。记录两组患者气管插管时(T1)、手术进行60 min时(T2)、手术完成时(T3),血清皮质醇(Cor)、肾上腺素(E)水平,心率(HR)和平均动脉压(MAP),并记录术中出血量、手术时间、术后拔出胸管时间、住院时间和并发症情况,检测手术前后用力肺活量(FVC)、第一秒用力呼气容积(FEV1)、呼气峰流速(PEF)和生活质量。结果:与T1时比较,对照组患者在T2、T3时HR、MAP明显升高(P<0.05);观察组在T2、T3时HR、MAP较T1无明显变化(P>0.05)。与T1时比较,两组T2、T3时Cor和E水平均升高,其中观察组Cor和E水平低于同期对照组(P<0.05)。手术后,两组FVC、FEV1、PEF均明显降低,但观察组FVC、FEV1、PEF水平高于对照组(P<0.05)。手术后,两组生活质量各项评分均升高,且观察组高于对照组(P<0.05)。观察组术中出血量、术后拔出胸管时间、住院时间和并发症发生率少于对照组,手术时间多于对照组(P<0.05)。结论:对非小细胞肺癌患者行袖状切除术,应激反应和肺功能影响小,术后并发症少,能有效提高生活质量。

Objective:To investigate the effects of radical sleeve resection of lung cancer on stress response,pulmonary function and quality of life in non-small cell lung cancer.Methods:Ninety-six patients with non-small cell lung cancer admitted to our hospital from February 2014 to December 2017 were divided into control group and observation group by random number table method.The control group received pneumonectomy.Sleeve resection was performed in observation group.The levels of serum cortisol(Cor),epinephrine(E),heart rate(HR)and mean arterial pressure(MAP)at intubation(T1),60 minutes after operation(T2),and completion of operation(T3)were recorded.The amount of bleeding during operation,operation time,time of thoracic tube extraction after operation,hospital stay and complications were recorded.The forced vital capacity(FVC)and the number of complications before and after operation were measured.One second forced expiratory volume(FEV1)and peak expiratory flow(PEF)and quality of life.Results:Compared at the T1,HR and MAP in control group increased significantly at T2 and T3(P<0.05).HR and MAP did not change significantly at T2 and T3 in observation group compared at T1(P>0.05).Compared at the T1,Cor and E levels increased at T2 and T3 in both groups,Cor and E levels in observation group were lower than those in control group at the same time(P<0.05).After operation,the levels of FVC,FEV1 and PEF in the observation group were higher(P<0.05).After operation,the scores of quality of life in both groups increased,and the observation group was higher(P<0.05).The incidence of intraoperative bleeding,chest tube extraction time,hospitalization time and complications in the observation group were less,and the operation time was more(P<0.05).Conclusion:Sleeve resection for non-small cell lung cancer has little effect on stress response and pulmonary function,less complications and can effectively improve the quality of life.