单孔电视胸腔镜肺叶切除术联合疼痛管理在早期肺癌中的疗效观察

Observation on curative effect of single-port videoassisted thoracoscopic lobectomy combined with pain management in early lung cancer

目的研究单孔电视胸腔镜肺叶切除术联合疼痛管理在早期肺癌中的临床疗效。方法选取2018年12月至2020年6月本院收治的60例早期肺癌患者作为研究对象,依据随机数字表法分为对照组和观察组,每组30例。对照组采用传统胸腔镜三孔法联合疼痛管理治疗,观察组采用单孔电视胸腔镜肺叶切除术联合疼痛管理治疗。两组术后均随访2个月。比较两组手术指标及术后1、5 d VAS评分;比较两组手术前、术后1 d外周血CD4^(+)、CD8^(+)水平、CD4^(+)/CD8^(+)比值及血清EGFR、VEGF水平。结果观察组术后首次下床时间、住院时间均短于对照组,且术后1、5 d VAS评分均明显低于对照组(P<0.05);术后1 d两组外周血CD4^(+)、CD8^(+)、血清EGFR、VEGF水平及CD4^(+)/CD8^(+)比值均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论单孔电视胸腔镜肺叶切除术联合疼痛管理可有效缩短早期肺癌患者的治疗时间且恢复效果良好,对免疫功能的影响较小,并抑制肿瘤细胞发展,值得临床推广应用。

Objective To study the clinical effect of single-port video-assisted thoracoscopic lobectomy combined with pain management in early lung cancer.Methods 60 patients with early lung cancer admitted to our hospital from December 2018 to June 2020 were selected as the study subjects,and they were divided into control group and observation group according to random number table method,with 30 cases in each group.The control group was treated with traditional thoracoscopic three-hole method combined with pain management,while the observation group was treated with single-port video-assisted thoracoscopic lobectomy combined with pain management.Both groups were followed up for 2 months.The operation-related indexes and DVAS scores at 1 and 5 days after operation were compared between the two groups.The levels of CD4^(+),CD8^(+)in peripheral blood,CD4^(+)/CD8^(+)ratio,serum EGFR and VEGF were compared between the two groups before and 1 day after operation.Results The first time to get out of bed and stay in hospital in the observation group were shorter than those in the control group,and the VAS scores at 1 and 5days after operation were significantly lower than those in the control group(P<0.05).1 day after operation,the levels of CD4^(+),CD8^(+),serum EGFR and VEGF and CD4^(+)/CD8^(+)ratio of two groups were lower than before operation,and the observation group was lower than control group,and the difference was statistically significant(P<0.05).Conclusion Single-port video-assisted thoracoscopic lobectomy combined with pain management can effectively shorten the treatment time of patients with early lung cancer with good recovery effect,it has little effect on immune function and inhibits the development of tumor cells,which is worthy of clinical application.