局限性切除术与完全肺叶切除术对Ⅰ期非小细胞肺癌患者预后的影响

Effect of Limited Resection and Complete Lobectomy on Prognosis of Patients with Stage Ⅰ Non-Small Cell Lung Cancer

目的:探讨局限性切除与完全肺叶切除对Ⅰ期非小细胞肺癌患者预后的影响。方法:选取2018年1月-2019年1月本院收治的95例Ⅰ期非小细胞肺癌患者,依据治疗方案不同分为对照组(n=50)和观察组(n=45)。对照组实施完全肺叶切除术,观察组实施局限性切除术。比较两组手术情况、安全性、随访两组术后2年总生存率和复发率及手术前和手术后1周的肺功能。结果:观察组术中出血量、住院时间、术后VAS评分均少于对照组,差异均有统计学意义(P<0.05);两组手术时间比较,差异无统计学意义(P>0.05)。术前,两组FVC%pred、FEV1%pred、MVV%pred比较,差异均无统计学意义(P>0.05);术后1周,两组FVC%pred、FEV1%pred、MVV%pred较术前明显降低,但观察组较对照组明显更高,差异均有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。观察组术后2年复发率高于对照组,差异有统计学意义(P<0.05);两组术后2年总生存率比较,差异无统计学意义(P>0.05)。结论:局限性切除术与完全肺叶切除术治疗Ⅰ期非小细胞肺癌患者的临床效果及术后短期预后相当,尽管后者可有效降低远期复发率,但前者具备术中出血少、住院时间短、手术安全性好及保护肺功能的优势。

Objective:To investigate the effect of limited resection and complete lobectomy on the prognosis of patients with stageⅠnon-small cell lung cancer.Method:A total of 95 patients with stageⅠnon-small cell lung cancer admitted to the hospital from January 2018 to January 2019 were selected,they were divided into control group(n=50)and observation group(n=45)according to the treatment method.The control group was treated with complete lobectomy,and the observation group was treated with limited resection.The surgical conditions,safety,2-year survival rate,recurrence rate were compared between two groups,and the lung function before and 1 week after surgery were compared between two groups.Result:The amount of intraoperative blood loss,length of hospital stay and postoperative VAS scores of observation group were lower than those of control group,the difference were statistically significant(P<0.05);there was no significant difference in surgical time between two groups(P>0.05).Before surgery,there were no significant differences in FVC%pred,FEV1%pred,MVV%pred between two groups(P>0.05);1 week after surgery,FVC%pred,FEV1%pred,MVV%pred of two groups were significantly lower than before operation,but the observation group were significantly higher than those of the control group,the differences were statistically significant(P<0.05).The incidence of complications of observation group was lower than that of control group,the difference was statistically significant(P<0.05).The recurrence rate of observation group was higher than that of control group 2 years after surgery,and the difference was statistically significant(P<0.05).There was no significant difference in 2-year survival rate between two groups(P>0.05).Conclusion:Limited resection and complete lobectomy have equivalent clinical effects and short-term prognosis in patients with stageⅠnonsmall cell lung cancer.Although the latter can effectively reduce the long-term recurrence rate,the former has the advantages of less intraoperative bleeding,shorter hospital stay,good safety and protection of lung function.