电视胸腔镜手术与传统手术治疗老年小结节非小细胞肺癌患者的效果比较

Comparison of effects of video-assisted thoracoscopic surgery and traditional surgery in treatment of elderly patients with small nodule non-small cell lung cancer

目的:比较电视胸腔镜手术与传统手术治疗老年小结节非小细胞肺癌患者的效果。方法:选取254例老年小结节非小细胞肺癌患者为研究对象,按照摸球法分为观察组与对照组各127例。对照组实施传统开胸肺叶切除术治疗,观察组实施电视胸腔镜肺叶切除术治疗,比较两组手术相关指标(术中出血量、淋巴结清扫个数、引流管留置时间、住院时间)水平、肺功能指标[最大通气量(MVV)、用力肺活量(FVC)]水平、炎性因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]水平和并发症发生率。结果:观察组术中出血量低于对照组,引流管留置时间和住院时间均短于对照组,差异有统计学意义(P<0.05);术后1周,两组MVV和FVC水平均低于术前,但观察组高于对照组,差异有统计学意义(P<0.05);术后1周,两组TNF-α和CRP水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);住院期间,观察组并发症发生率为6.30%,明显低于对照组的21.26%,差异有统计学意义(P<0.05);两组淋巴结清扫个数比较,差异无统计学意义(P>0.05)。结论:电视胸腔镜肺叶切除术治疗老年小结节非小细胞肺癌患者可降低术中出血量、并发症发生率和炎性因子水平,缩短引流管留置时间和住院时间,以及提高肺功能指标水平,效果优于传统开胸肺叶切除术。

Objective:To compare effects of video-assisted thoracoscopic surgery and traditional surgery in treatment of elderly patients with small nodule non-small cell lung cancer.Methods:254 elderly patients with small nodule non-small cell lung cancer were selected as the research objects,and were divided into observation group and control group according to the ball touching method,127 cases in each.The control group was treated with traditional thoracotomy lobectomy,while the observation group was treated with video-assisted thoracoscopic lobectomy.The levels of surgery-related indicators(intraoperative blood loss,number of lymph nodes dissected,drainage tube indwelling time,hospitalization time),the pulmonary function indicator(maximum ventilation ventilation(MVV),forced vital capacity(FVC)]levels,the inflammatory factor[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)]levels and the incidences of complications were compared between the two groups.Results:The intraoperative blood loss in the observation group was lower than that in the control group;the drainage tube indwelling time and the hospitalization time were shorter than those in the control group;and the differences were statistically significant(P<0.05).One week after the surgery,the levels of MVV and FVC in both groups were lower than those before the surgery;however,those of the observation group were higher than those of the control group;and the differences were statistically significant(P<0.05).One week after the surgery,the levels of TNF-αand CRP in the two groups were higher than those before the surgery;but those of the observation group were lower than those of the control group;and the differences were statistically significant(P<0.05).During the hospitalization,the incidence of complications in the observation group was 6.30%,which was significantly lower than 21.26% in the control group,and the difference was statistically significant(P<0.05).However,there was no significant difference in the number of lymph nodes dissected between the two groups(P>0.05).Conclusions:Video-assisted thoracoscopic lobectomy in the treatment of the elderly patients with small nodule non-small cell lung cancer can reduce the amount of intraoperative blood loss,the incidence of complications and the levels of inflammatory factors,shorten the drainage tube indwelling time and the hospitalization time,and improve the levels of pulmonary function indicators.Moreover,it is superior to traditional thoracotomy lobectomy.