用VATS下肺楔形切除术治疗老年早期非小细胞肺癌的疗效及安全性研究

Study on the efficacy and safety of VATS subwedge pulmonary resection in the treatment of senile early non-small cell lung cancer

目的:研究用胸腔镜(VATS)下肺楔形切除术治疗老年早期非小细胞肺癌的临床疗效及安全性。方法:将2020年4月至2021年3月期间在重庆市璧山区人民医院接受治疗的60例老年早期小细胞肺癌患者随机分成肺叶切除组(n=30)和肺楔形切除组(n=30)。为肺叶切除组患者采用肺叶切除术进行治疗,为肺楔形切除组患者采用VATS下肺楔形切除术进行治疗,然后比较两组患者的围手术期指标、实验室检查指标、肺功能指标、VAS评分和术后并发症的发生率。结果:肺楔形切除组患者的手术时间、术后下床活动的时间、术后首次进食的时间、术后留置引流管的时间、住院时间均优于肺叶切除组患者,P<0.05。治疗后,肺楔形切除组患者的VC、FEV_(1)、MVV、VAS评分、术后并发症的发生率、血清IGF-1R、S100A2的水平均优于肺叶切除组患者,P<0.05。结论:用VATS下肺楔形切除术治疗老年早期非小细胞肺癌的临床疗效显著,且安全性高。

Objective:To study the clinical efficacy and safety of video-assisted thoracoscopic(VATS)wedge resection of lung in the treatment of early senile non-small cell lung cancer.Methods:A total of 60 elderly patients with early smallcell lung cancer who were treated in Bishan District People’s Hospital of Chongqing from April 2020 to March 2021 were randomly divided into lobectomy group(n=30)and wedge resection group(n=30).Patients in the lobectomy group were treated with lobectomy and patients in the wedge resection group were treated with wedge resection under VATS.Then,perioperative indicators,laboratory examination indicators,pulmonary function indicators,VAS scores and the incidence of postoperative complications were compared between the two groups.Results:The operation time,postoperative ambulation time,postoperative first feeding time,postoperative indwelling drainage tube time and hospital stay time of patients in the pulmonary wedge rese ction group were better than those in the pulmonary lobectomy group,P<0.05.After treatment,VC,FEV_(1),MVV,VAS scores,incidence of postoperative complications,serum IGF-1R and S100A2 levels in patients with pulmonary wedge resection were better than those in patients with pulmonary lobectomy,P<0.05.Conclusion:Wedge resection under VATS is effective and safe in the treatment of senile early non-small cell lung cancer.