胸腔镜肺癌手术治疗老年非小细胞肺癌的临床疗效及不良反应发生率分析

Analysis of Clinical Efficacy and Ineidence of Adverse Reaction of Thoracoscopic Lung Cancer Surgery in the Treatment of Elderly Non-small Cell Lung Cancer

目的探讨临床在治疗非小细胞肺癌老年患者时,以胸腔镜肺癌手术展开治疗干预的疗效与不良反应发生情况。方法随机选取2018年1月—2020年12月来该院就医的100例非小细胞肺癌老年患者,采用回顾性分析研究,其中45例实施传统开胸术治疗,55例患者实施胸腔镜微创手术,比较两组临床疗效、手术指标、远期疗效及肿瘤复发情况。结果经对比两组疗效,胸腔镜组比开胸组高,但差异无统计学意义(P>0.05);经对比两组各项手术指标,胸腔镜组手术时间、术中出血量、术后引流管留置时间、住院时间、首次下床时间、疼痛评分及气促感症状持续时间低于开胸组,差异有统计学意义(t=4.679、2.999、11.219、9.569、10.577、9.611、3.094,P<0.05),但两组手术费用比较,差异无统计学意义(t=0.462,P>0.05);经对比两组术后并发症发生情况,胸腔镜组总发生率3.6%比开胸组20.0%低,差异有统计学意义(χ^(2)=6.769,P<0.05);经对比术后两组肋骨骨折发生率,胸腔镜总发生率0.0%比开胸组11.1%低,差异有统计学意义(χ^(2)=4.306,P<0.05);经对比两组手术后生存率及肿瘤复发率,与开胸组相比,胸腔镜组生存率96.4%较高、复发率5.5%较低,但差异无统计学意义(χ^(2)=1.131、1.037,P>0.05)。结论临床在治疗非小细胞肺癌老年患者时,与常规开胸术相比,以胸腔镜肺癌手术治疗,可取得显著效果,既能够可有效缩短患者手术时间和住院时间,促进其尽快康复的同时,还能够降低其术后发生并发症、肋骨骨折及肿瘤复发风险,进一步提高患者生存质量与生存率,适合深入展开研究与推广。

Objective To explore the clinical efficacy and adverse reactions of thoracoscopic lung cancer surgery in the treatment of elderly patients with non-small cell lung cancer.Methods Randomly Selected 100 elderly patients with non-small cell lung cancer who came to the hospital for treatment from January 2018 to December 2020.The retrospective analysis was conducted.Among them,45 patients underwent traditional thoracotomy treatment and 55 patients underwent thoracoscopic minimally invasive surgery.Comparison of the two groups of clinical efficacy,surgical indicators,long-term efficacy and tumor recurrence.Results After comparing the two groups,the effect of thoracoscopy group was higher than that of thoracotomy group,but the difference was not statistically significant(P>0.05).Compared with the two groups,the operation time,intraoperative blood loss,postoperative drainage tube indwelling time,length of hospital stay,time to get out of bed for the first time,pain score and duration of shortness of breath symptoms in the thoracoscopic group were lower than those in the thoracotomy group,the difference was statistically significant(t=4.679,2.999,11.219,9.569,10.577,9.611,3.094,P<0.05).However,there was no statistically significant difference between the surgical costs of the two groups(t=0.462,P>0.05).After comparing the incidence of postoperative complications between the two groups,the total incidence of 3.6% in the thoracoscopic group was lower than 20.0% in the thoracotomy group,the difference was statistically significant(χ^(2)=6.769,P<0.05).After comparison of the incidence of rib fracture between the two groups,the total incidence of 0.0%thoracoscopy was lower than that of 11.1% thoracotomy group,the difference was statistically significant(χ^(2)=4.306,P<0.05).Compared with the thoracotomy group,the postoperative survival rate and tumor recurrence rate were 96.4% higher in the thoracoscopic group and 5.5% lower in the thoracoscopic group,but the difference was not statistically significant(χ^(2)=1.131,1.037,P>0.05).Conclusion In the clinical treatment of elderly patients with non-small cell lung cancer,compared with conventional thoracotomy,thoracoscopic lung cancer surgery can achieve significant results.It not only can effectively shorten the operation time and hospital stay of patients,and promote their recovery as soon as possible,but also reduce the risk of postoperative complications,rib fractures and tumor recurrence,and further improve the quality of life and survival rate of patients,suitable for in-depth research and promotion.