胸腔镜肺叶切除术与常规开胸手术治疗肺癌的效果及并发症发生情况比较

Comparison of the effects and complications of thoracoscopic lobectomy and conventional thoracotomy in the treatment of lung cancer

目的比较胸腔镜肺叶切除术与常规开胸手术治疗肺癌的效果及并发症发生情况。方法依据手术方法将50例肺癌患者分为观察组(胸腔镜肺叶切除术)和对照组(常规开胸手术),各25例。比较两组的手术相关指标、心功能指标[心率(HR)、左室射血分数(LVEF)、左心室舒张末期容积(LVEDV)、左心室收缩末期内径(LVESD)]、肺功能指标[呼气流量峰值(PEF)、第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)]及并发症发生情况。结果观察组的手术时间、引流管留置时间显著短于对照组,术中出血量、引流量显著少于对照组,差异具有统计学意义(P<0.05)。手术后,两组的HR、LVEDV、LVESD均低于手术前,LVEF高于手术前,且观察组优于对照组,差异具有统计学意义(P<0.05)。手术后,两组的PEF、FEV_(1)、FVC均高于手术前,且观察组高于对照组,差异具有统计学意义(P<0.05)。观察组的术后并发症总发生率低于对照组,差异具有统计学意义(P<0.05)。结论与常规开胸手术比较,采用胸腔镜肺叶切除术治疗肺癌可优化手术相关指标,减少对心、肺功能的影响,降低术后并发症发生率。

Objective To compare the effects and complications of thoracoscopic lobectomy and conventional thoracotomy in the treatment of lung cancer.Methods Fifty patients with lung cancer were divided into observation group(thoracoscopic lobectomy)and control group(conventional thoracotomy)according to the surgical methods,with 25 cases in each group.The operation related indexes,cardiac function indexes[heart rate(HR),left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic diameter(LVESD)],pulmonary function indexes[peak expiratory flow(PEF),forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC)and complications of the two groups were compared.Results The operation time and indwelling time of drainage tube in the observation group were significantly shorter than those in the control group,the intraoperative bleeding volume and drainage volume were significantly less than those in the control group,and the differences were statistically significant(P<0.05).After operation,HR,LVEDV and LVESD in the two groups were lower than those before operation,LVEF was higher than that before operation,those in the observation group were better than the control group,and the differences were statistically significant(P<0.05).After operation,PEF,FEV_(1) and FVC in the two groups were higher than those before operation,those in the observation group were higher than the control group,and the differences were statistically significant(P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with conventional thoracotomy,thoracoscopic lobectomy in the treatment of lung cancer can optimize the relevant indexes,reduce the impacts on cardiac and pulmonary function,and decrease the incidence of postoperative complications.