胸腔镜与开胸肺叶切除术治疗非小细胞肺癌的随机对照研究

A randomized controlled study of thoracoscopy and thoracotomy lobectomy in the treatment of non-small cell lung cancer

目的:探讨胸腔镜与开胸肺叶切除术治疗非小细胞肺癌的疗效。方法:选择2017年11月—2019年5月江西省丰城市人民医院心胸外科收治的非小细胞肺癌患者72例,依据随机对照原则分为两组,每组36例。对照组采取开胸肺叶切除术治疗。观察组采取腹腔镜肺叶切除术治疗。观察手术情况(手术切口、手术时间、术中出血量、清扫淋巴结数目)、免疫功能(CD3^+、CD4^+、CD8^+、CD4^+/CD8^+)改善情况。结果:观察组手术切口、术中出血量均低于对照组(P<0.05);观察组和对照组干预前后CD8^+水平变化对比差异无统计学意义(P>0.05);观察组免疫指标CD3^+、CD4^+、CD4^+/CD8^+水平高于干预前和对照组(P<0.05)。结论:胸腔镜与开胸肺叶切除术治疗非小细胞肺癌疗效有一定差异,对比而言,胸腔镜疗效较好,患者免疫功能改善较好。

Objective:To investigate the efficacy of thoracoscopic and thoracotomy lobectomy in the treatment of nonsmall cell lung cancer.Methods:Seventy-two patients with non-small cell lung cancer admitted to the Department of Cardiothoracic Surgery,Fengcheng People’s Hospital of Jiangxi Province from November 2017 to May 2019 were selected and according to the principle of random control,divided into two groups with 36 cases in each group.The control group was treated with thoracotomy lobectomy.The observation group was treated with laparoscopic lobectomy.The operation conditions(incision,operation time,intraoperative blood loss,number of lymph node dissection)and the improvement of the immune function(CD3^+,CD4^+,CD8^+,CD4^+/CD8^+)were observed.Results:The surgical incision and intraoperative blood loss in the observation group were lower than those in the control group(P<0.05);the observation group and the control group had no significant difference in CD8^+levels before and after intervention(P>0.05);the levels of immune indexes CD3^+,CD4^+,CD4^+/CD8^+in the observation group were higher than those before the intervention and in the control group(P<0.05).Conclusion:There are certain differences in the efficacy of thoracoscopy and thoracotomy lobectomy in the treatment of non-small cell lung cancer,in contrast,thoracoscopy has better curative effect,and the patient’s immune function has been improved better.