胸腔镜下肺叶切除术和肺段切除术治疗老年早期非小细胞肺癌的效果比较

Effect comparison of thoracoscopic lobectomy and segmentectomy in the treatment of aged patients with early stage non-small cell lung cancer

目的研究胸腔镜下不同手术切除范围对老年早期非小细胞肺癌的干预效果。方法将2016年7月至2018年7月南通大学附属如皋医院收治的86例老年早期非小细胞肺癌患者以随机数字表法分为观察组与对照组,每组43例。对照组胸腔镜下行肺叶切除术,观察组胸腔镜下行肺段切除术。比较两组手术时间、术中出血量、淋巴结切除数量、术后视觉模拟评分法(VAS)评分、引流时间、住院时间,比较两组手术前后C反应蛋白(CRP)、前清蛋白(PA)、血糖水平,记录两组住院期间并发症发生情况。结果观察组手术时间长于对照组,引流时间、住院时间短于对照组,差异有统计学意义(P<0.05)。两组淋巴结切除数量、术后VAS评分比较,差异无统计学意义(P>0.05)。两组术后CRP、血糖水平高于术前,PA低于术前,且观察组CRP、血糖水平低于对照组,PA高于对照组,差异有统计学意义(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论与胸腔镜下肺叶切除术比较,胸腔镜下肺段切除术治疗早期老年非小细胞肺癌可缩短引流时间、住院时间,应当给予关注。

Objective To study the intervention effect of different thoracoscopic surgical resection scope on aged patients with early stage non-small cell lung cancer.Methods A total of 86 aged patients with early stage non-small cell lung cancer admitted to Rugao Hospital Affiliated to Nantong University from July 2016 to July 2018 were divided into observation group and control group by random number table method,with 43 cases in each group.The control group underwent thoracoscopic lobectomy,and the observation group underwent thoracoscopic segmentectomy.The operative time,intraoperative blood loss,number of lymph node resection,postoperative visual analogue scale(VAS)score,drainage time,and hospitalization time between the two groups were compared.The levels of C-reactive protein(CRP),proalbumin(PA),and blood glucose were compared between the two groups before and after operation,and the incidence of complications during hospitalization was recorded.Results The operation time of the observation group was longer than that of the control group,and the drainage time and hospitalization time were shorter than those of the control group,the differences were statistically significant(P<0.05).There was no significant difference in the number of lymph node resection and postoperative VAS score between the two groups(P>0.05).The levels of CRP and blood glucose in the two groups were higher than those before operation,while PA was lower than that before operation,and CRP and blood glucose levels in the observation group were lower than those in the control group,while PA levels were higher than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Compared with thoracoscopic lobectomy,thoracoscopic segmental lung resection in the treatment of aged patients with early stage non-small cell lung cancer can shorten the drainage time and hospital stay,which should be paid attention to.