胸腔镜肺癌根治术对肺癌患者炎症及应激反应指标的影响

The effect of thoracoscopic radical resection of lung cancer on inflammation and stress response in patients with lung cancer

目的研究胸腔镜肺癌根治术对肺癌患者炎症及应激反应指标的影响。方法选取2016年1月至2018年12月本院收治的80例肺癌患者为研究对象,按照入院编码奇偶数分为观察组和对照组,每组40例。对照组行传统开胸肺癌根治术治疗,观察组行胸腔镜肺癌根治术治疗。比较两组手术时间、术中出血量、置管时间及术后并发症发生率;比较术前及术后1、3 d两组血清炎症指标[白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]和疼痛应激指标[P物质(SP)、前列腺素E2(PGE2)、缓激肽(BK)]。结果观察组术中出血量少于对照组,置管时间短于对照组,并发症发生率低于对照组,差异有统计学意义(P<0.05);术后1、3 d,观察组血清IL-6、TNF-α、CRP指标均低于对照组(P<0.05),平均血清SP、PGE2、BK指标也均低于对照组(P<0.05)。结论相较于传统开胸术,胸腔镜肺癌根治术具有疗效佳、创伤小、术后并发症少的优点,能有效降低患者术后炎症和应激反应。

Objective To study the effect of thoracoscopic radical resection of lung cancer on inflammation and stress response in patients with lung cancer.Methods 80 cases of lung cancer patients in our hospital from January 2016 to December 2018 were selected as the research subjects,and they were divided into observation group and control group according to the odd even number of admission codes,with 40 cases in each group.The control group was treated with traditional thoracotomy and the observation group was treated with thoracoscopic radical surgery.The operation time,intraoperative blood loss,catheterization time and incidence of postoperative complications were compared between the two groups;the serum inflammatory indexes[interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)]and pain stress indexes[substance P(SP),prostaglandin E2(PGE2),bradykinin(BK)]were detected before operation and on the first and third days after operation were compared between the two groups.Results The intraoperative blood loss of the observation group was less than that of the control group,the catheterization time was shorter than that of the control group,the postoperative complications were lower than that of the control group,the difference was statistically significant(P<0.05);the serum IL-6,TNF-α,CRP indexes of the observation group were lower than those of the control group(P<0.05),and the serum SP,PGE2,BK indexes were also lower than those of the control group(P<0.05).Conclusion Compared with the traditional thoracotomy,thoracoscopic radical surgery for lung cancer has the advantages of better curative effect,less trauma and fewer postoperative complications,which can effectively reduce the postoperative inflammatory response and stress response of patients.