胸腔镜下肺段与肺楔形切除术治疗肺磨玻璃结节的短期预后比较

Comparison of short-term prognosis of patients with ground glass pulmonary nodules after thoracoscopic segmentectomy versus wedge resection

目的比较胸腔镜下肺段与肺楔形切除术治疗肺磨玻璃结节的短期预后。方法抽取2017年6月至2019年12月苏州大学附属常熟医院收治的肺磨玻璃结节患者99例,依据手术方案将其分为两组。对照组50例行胸腔镜下肺段切除术,观察组49例行胸腔镜下肺楔形切除术。回顾性对照分析两组短期预后、围术期指标及术后并发症。结果术后随访6个月,两组均无复发、转移及死亡病例。观察组出血量、手术时间、胸管留置时间、住院时间少于对照组(t=8.982、5.730、6.702、14.421,P<0.05)。对照组、观察组术后3 d视觉模拟量表评分低于术后1 d(t=5.523、10.740,P<0.05),且观察组低于对照组(t=5.662,P<0.05)。观察组并发症发生率(6.12%,3/49)低于对照组(16.00%,8/50),但差异未见统计学意义(χ^(2)=2.445,P=0.118)。结论胸腔镜下肺段与肺楔形切除术治疗肺磨玻璃结节短期预后良好,胸腔镜下肺楔形切除术手术损伤较小,有利于缓解术后疼痛。

Objective To investigate the short-term prognosis of patients with ground glass pulmonary nodules after thoracoscopic segmental and wedge resection.Methods A total of 99 patients with ground glass pulmonary nodules admitted to Changshu Hospital Affiliated to Soochow University from June 2017 to December 2019 were selected and divided into two groups according to the surgical plan.Fifty patients in the control group underwent thoracoscopic segmentectomy,and 49 patients in the observation group underwent thoracoscopic wedge resection.The short-term prognosis,perioperative indicators and postoperative complications in the two groups were retrospectively analyzed.Results After 6 months of follow-up,there were no cases of recurrence,metastasis or death in the two groups.The amount of bleeding,operation time,chest tube indwelling time,and hospital stay in the observation group were less than those in the control group(t=8.982,5.730,6.702,14.421,P<0.05).The visual analogue scale scores of the control group and the observation group were lower than those of the control group after 3 days of operation(t=5.523,10.740,P<0.05),and the observation group was lower than the control group(t=5.662,P<0.05).The incidence of complications in the observation group(6.12%,3/49)was lower than that in the control group(16.00%,8/50),but the difference was not significant(χ^(2)=2.445,P=0.118).Conclusions The short-term prognosis of patients with GGO treated by thoracoscopic pulmonary wedge resection and segmental resection is good,but the injury of thoracoscopic wedge resection is less,it is more conducive to reduce postoperative pain.