单孔单向式全胸腔镜肺叶切除术结合化疗治疗肺癌患者的效果研究

Study on the Effect of Single-port Unidirectional Total Thoracoscopic Lobectomy Combined with Chemotherapy in the Treatment of Lung Cancer Patients

目的:探讨单孔单向式全胸腔镜肺叶切除术联合化疗对肺癌患者免疫功能及近远期疗效的影响。方法:选取2018年1月—12月于我院治疗肺癌患者60例,按照治疗方法不同分单一手术组26例和结合化疗组34例。单一手术组采用单孔单向式全胸腔镜肺叶切除术,结合化疗组在其基础上联合培美曲塞+顺铂联合吉非替尼化疗治疗。比较两组近远期疗效、肺功能指标、生活质量、血清疼痛相关因子、免疫功能。结果:结合化疗组住院时间短于单一手术组,术后3 d引流量多于单一手术组,复发率低于单一手术组(P<0.05);两组手术后FVC、FEV1、MVV低于手术前,而结合化疗组高于单一手术组(P<0.05);两组手术后功能、症状、整体及总分高于手术前,且结合化疗组高于单一手术组(P<0.05);两组手术后NE、SP、Cor水平高于手术前,而结合化疗组低于单一手术组(P<0.05);两组手术后CD4^(+)、CD4^(+)/CD8^(+)低于手术前,CD8^(+)高于手术前,且结合化疗组CD4^(+)、CD4^(+)/CD8^(+)低于单一手术组,CD8^(+)高于结合化疗组(P<0.05);结合化疗组1、3年生存率高于单一手术组,1、3年生存率、复发率低于单一手术组(P<0.05)。结论:单孔单向式全胸腔镜肺叶切除术联合化疗可改善肺癌患者近远期疗效、免疫功能抑制,对肺功能的保护更有利,降低疼痛相关因子水平,有助于增强治疗效果。

Objective:To explore the effect of single-port unidirectional total thoracoscopic lobectomy combined with chemotherapy on immune function and long-term efficacy in lung cancer patients.Methods:A total of 60 patients with lung cancer treated in our hospital from January 2018 to December 2018 were selected and divided into single operation group(26 cases)and combined chemotherapy group(34 cases)according to different treatment methods.Single operation group was treated with single-port unidirectional total thoracoscopic lobectomy,combined with chemotherapy group on the basis of pemetrexedcisplatin combined with gefitinib chemotherapy.The short and long term efficacy,pulmonary function indexes,quality of life,serum pain related factors and immune function were compared between the two groups.Results:The hospitalization time of the combined chemotherapy group was shorter than that of the single operation group,the drainage volume 3 d after operation was more than that of the single operation group,and the recurrence rate was lower than that of the single operation group(P<0.05).FVC,FEV1 and MVV in the two groups after operation were lower than those before operation,while those in the combined chemotherapy group were higher than those in the single operation group(P<0.05).The function,symptoms,overall and total scores of the two groups after operation were higher than those before operation,and the combination chemotherapy group was higher than the single operation group(P<0.05).The levels of NE,SP and Cor in the two groups after operation were higher than those before operation,while those in the combined chemotherapy group were lower than those in the single operation group(P<0.05).After operation,CD4+and CD4+/CD8+in the two groups were lower than those before operation,and CD8+was higher than that before operation,and CD4+and CD4+/CD8+in the combined chemotherapy group were lower than those in the single operation group,and CD8+was higher than that in the combined chemotherapy group(P<0.05).The 1-and 3-year survival rates in the combined chemotherapy group were higher than those in the single operation group,and the 1-and 3-year recurrence rates were lower than those in the single operation group(P<0.05).Conclusion:Single-port unidirectional total thoracoscopic lobectomy combined with chemotherapy can improve the short-term and long-term efficacy and immune function inhibition of lung cancer patients,which is more beneficial to the protection of lung function,reduce the level of pain related factors,and help to enhance the therapeutic effect.