模式化单孔与传统三孔胸腔镜在肺癌根治术中的应用对比

Comparison on the application of modular single-port and traditional three-port thoracoscopy in radical resection of lung cancer

目的:探究模式化单孔与传统三孔胸腔镜在肺癌根治术中的应用价值。方法:选取2019年12月~2021年9月在本院行胸腔镜肺癌根治术的患者120例,应用随机数字表法分为观察组(n=60)和对照组(n=60),观察组行模式化单孔胸腔镜肺癌根治术,对照组行传统三孔胸腔镜肺癌根治术。比较两组患者手术与术后相关指标,术后近期1 d、3d、5 d疼痛程度与止痛药使用情况,术前与术后1d患者机体应激与炎性指标水平、免疫因子水平,并记录手术后相关并发症发生情况。结果:观察组术中出血量与术后引流量明显少于对照组,术后下床与住院时间明显短于对照组;术后1 d、3 d观察组患者疼痛评分明显低于对照组,观察组止痛药使用时间明显短于对照组;术后观察组去甲肾上腺素(NE)、降钙素原(PCT)、C反应蛋白(CRP)水平明显低于对照组;术后观察组T细胞亚群CD3^(+)、CD4^(+)及CD4^(+)/ CD8^(+)水平明显高于对照组;术后两组并发症发生率比较无明显差异。结论:模式化单孔胸腔镜肺癌根治术较传统三孔根治术治疗效果更佳,可有效改善手术相关指标,缩短术后恢复时间,减轻术后疼痛和炎性反应,调控机体免疫功能,加快患者术后康复。

Objective To explore the application value of modular single-port and traditional three-port thoracoscopy in radical resection of lung cancer.Methods A total of 120 patients undergoing thoracoscopic radical resection of lung cancer in the hospital were enrolled between December 2019 and September 2021.According to random number table method,they were divided into observation group (n=60) and control group (n=60).The observation group underwent modular single-port thoracoscopic radical resection of lung cancer,while control group underwent traditional three-port thoracoscopic radical resection of lung cancer.The surgical and postoperative related indexes,pain level and usage of analgesics at 1d,3d and 5d after surgery,levels of body stress,inflammatory indexes and immune factors before and at 1d after surgery were compared between the two groups.The occurrence of postoperative related complications was recorded.Results The intraoperative blood loss and postoperative drainage volume in observation group were significantly lower than those in control group,leaving bed time and hospitalization time were significantly shorter than those in control group.At 1d and 3d after surgery,pain scores in observation group were significantly lower than those in control group,and usage time of analgesics was significantly shorter than that in control group.After surgery,levels of norepinephrine (NE),procalcitonin (PCT) and C-reactive protein (CRP) in observation group were significantly lower than those in control group,while levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were significantly higher than those in control group.There was no significant difference in the incidence of postoperative complications between the two groups.Conclusion Compared with traditional three-port thoracoscopy,curative effect of modular single-port thoracoscopic radical resection of lung cancer is more significant,which can effectively improve surgical related indexes,shorten postoperative recovery time,alleviate postoperative pain and inflammatory response,regulate immune function and accelerate postoperative rehabilitation.