单操作孔胸腔镜肺段与肺叶切除术对非小细胞肺癌患者炎性因子与免疫细胞的影响研究

Study on the effect of single-port thoracoscopic pulmonary segmentectomy and lobectomy on inflammatory factors and immune cells in patients with non-small cell lung cancer

目的探讨单操作孔胸腔镜肺段与肺叶切除术治疗非小细胞肺癌对患者外周血中炎性因子及免疫细胞的影响。方法118例非小细胞肺癌患者,按照随机数字表法分为对照组与观察组,各59例。对照组采取肺叶切除治疗,观察组采取单操作孔胸腔镜肺段治疗。比较两组手术前后炎性因子水平、免疫细胞水平及肺功能指标。结果术后,两组白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平均高于本组术前,但观察组低于对照组,差异均有统计学意义(P<0.05)。术后,两组CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平均低于本组术前,但观察组高于对照组,差异均有统计学意义(P<0.05)。观察组第1秒用力呼气容积(FEV1)为(1.98±0.07)L、用力肺活量(FVC)为(2.83±0.07)L、FEV1/FVC为(73.76±10.77)%,均优于对照组的(1.74±0.08)L、(2.41±0.03)L、(68.18±10.76)%,差异均有统计学意义(P<0.05)。结论与肺叶切除术相比,单操作孔胸腔镜肺段切除治疗能有效减轻非小细胞肺癌患者炎症反应,减少对免疫细胞、肺功能影响,更利于患者术后康复。

Objective To discuss the effect of single-port thoracoscopic pulmonary segmentectomy and lobectomy on inflammatory factors and immune cells in patients with non-small cell lung cancer.Methods A total of 118 patients with non-small cell lung cancer were divided into control group and observation group according to the random numerical table,with 59 cases in each group.The control group was treated with lobectomy,and the observation group was treated with single-port thoracoscopic pulmonary segmentectomy.The levels of inflammatory factors,immune cells and lung function indicators before and after surgery were compared between the two groups.Results After surgery,the levels of interleukin-6(IL-6),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α)in the two groups were higher than those before surgery in this group,but the observation group was lower than the control group.All the differences were statistically significant(P<0.05).After surgery,the levels of CD4^(+),CD8^(+),CD4^(+)/CD8^(+)in the two groups were lower than those before surgery in this group,but the observation group was higher than the control group.All the differences were statistically significant(P<0.05).In the observation group,the forced expiratory volume in the 1st second(FEV1)was(1.98±0.07)L,the forced vital capacity(FVC)was(2.83±0.07)L,and the FEV1/FVC was(73.76±10.77)%,which were all better than(1.74±0.08)L,(2.41±0.03)L,and(68.18±10.76)%in the control group,and the differences were statistically significant(P<0.05).Conclusion Compared with lobectomy,single-port thoracoscopic segmentectomy can effectively reduce the inflammatory response in patients with non-small cell lung cancer,reduce the impact on immune cells and lung function,and is more conducive to postoperative recovery.