单孔与三孔胸腔镜下部分肺叶切除术对非小细胞肺癌患者应激反应、炎症因子及TGF-α、CA21-1、EGFR水平的影响

Impacts of partial lobectomy under single-port or three-port thoracoscopy on stress reaction,inflammatory factors,TGF-α,CA21-1 and EGFR levels in patients with non-small cell lung cancer

目的探讨单孔与三孔胸腔镜下部分肺叶切除术对非小细胞肺癌患者应激反应、炎症因子及转化生长因子-α(TGF-α)、癌抗原(CA)21-1、表皮生长因子受体(EGFR)水平的影响。方法选取2018年1月至2019年11月阳江市人民医院收治的90例非小细胞肺癌患者,根据手术方案不同分为对照组与观察组,每组各45例。观察组采用单孔胸腔镜下部分肺叶切除术,对照组行三孔胸腔镜下部分肺叶切除术,对两组患者手术情况应激反应指标及炎症因子水平、TGF-α、CA21-1、EGFR水平进行比较。结果观察组手术时间、切口长度较对照组短,术中出血量较对照组低,差异有统计学意义(P<0.05);两组术前的血清肾上腺素(E)、去甲肾上腺素(NE)、皮质醇(Cor)等应激反应指标比较,差异无统计学意义(P>0.05),观察组术后1 d的上述指标明显较对照组低,差异有统计学意义(P<0.05);两组术前C反应蛋白(CRP)、白介素-6(IL-6)水平比较,差异无统计学意义(P>0.05),术后1 d,观察组IL-6、CRP均低于对照组,差异有统计学意义(P<0.05);两组术前的TGF-α、CA21-1、EGFR水平比较,差异无统计学意义(P>0.05),观察组术后1 d的上述指标低于对照组,差异有统计学意义(P<0.05)。结论单孔胸腔镜下部分肺叶切除术相较于三孔手术治疗非小细胞肺癌创伤小,可减轻机体应激反应,控制炎症因子水平,也有助于调节TGF-α、CA21-1、EGFR水平,值得推广。

Objective To investigate the impacts of partial lobectomy under single-port or three-port thoracoscopy on stress reaction,inflammatory factors,TGF-α,CA21-1 and EGFR levels in patients with non-small cell lung cancer.Methods A total of 90 patients with non-small cell lung cancer admitted to People's Hospital of Yangjiang from January 2018 to November 2019 were selected and divided into the control group(n=45)and the observation group(n=45)according to different surgical schemes.The observation group was treated with partial lobectomy under single-port thoracoscopy,while the control group was treated with partial lobectomy under three-port thoracoscopy.The opreation condition,levels of stress reaction indexes,inflammatory factors,TGF-α,CA21-1 and EGFR levels of the two groups of patients were compared.Results The operation time and incision length of the observation group were shorter than those of the control group,and the intraoperative hemorrhage volume was lower than that of the control group,with statistically significant differences(P<0.05).There were no statistically significant differences in serum adrenaline(E),norepinephrine(NE),cortisol(Cor),etc.,between the two groups before operation(P>0.05).The above indexes in the observation group on the first day after operation were significantly lower than those in the control group,with statistically significant differences(P<0.05).There were no statistically significant differences in C-reactive protein(CRP)and interleukin-6(IL-6)between the two groups before operation(P>0.05).On the first day after operation,IL-6 and CRP in the observation group were all lower than those in the control group,with statistically significant differences(P<0.05).There were no statistically significant differences in the levels of TGF-α,CA21-1 and EGFR between the two groups(P>0.05).There was statistically significant difference in the above indexes between the observation group and the control group on the first day after operation(P<0.05).Conclusion Compared with three-port surgery,partial lobectomy under single-port thoracoscopy has less trauma in the treatment of non-small cell lung cancer,which can reduce the stress reaction of the body,control the level of inflammatory factors,and is also helpful to regulate the levels of TGF-α,CA21-1 and EGFR.Therefore,it is worthy of promotion.