电视胸腔镜解剖性肺段切除术治疗早期非小细胞肺癌疗效及对血清C-反应蛋白、白细胞介素-1β、白细胞介素-6、肿瘤坏死因子-α水平的影响分析

Efficacy of video-assisted thoracoscopic anatomical segmental resection for early non-small cell lung cancer and its influence on serum CRP,IL-1β,IL-6 and TNF-α levels

目的 探讨电视胸腔镜系统(VATS)下解剖性肺段切除术与全胸腔镜肺叶切除术治疗早期非小细胞肺癌(NSCLC)疗效及对血清炎症因子的影响。方法 2018年1月~2020年1月我院胸外科治疗的早期NSCLC病人86例,根据手术方式分为两组,研究组45例,采用VATS下解剖性肺段切除术,对照组41例,采用VATS下肺叶切除术。比较两组手术效果、肺功能指标变化,检测治疗前后血清C-反应蛋白(CRP)、白细胞介素(IL)-1β、IL-6、肿瘤坏死因子(TNF)-α水平。结果 研究组手术时间、术中出血量、术后引流量、术后引流时间均高于对照组,差异有统计学意义(P<0.05);研究组住院时间低于对照组,差异有统计学意义(P<0.05);两组术中淋巴清扫数量比较差异无统计学意义(P>0.05)。两组术前FEV1%、FVC%、PEF肺功能指标比较,差异均无统计学意义(P>0.05);术后两组FEV1%、FVC%均低于术前,PEF高于术前,差异有统计学意义(P<0.05);研究组术后FEV1%、FVC%、PEF均高于对照组,差异有统计学意义(P<0.05)。两组术后1天、3天血清CRP、IL-1β、IL-6、TNF-α水平均高于术前,差异有统计学意义(P<0.05);术后1天血清CRP、IL-1β、IL-6、TNF-α水平高于术后3天,差异有统计学意义(P<0.05);研究组术后1天、3天血清CRP、IL-1β、IL-6、TNF-α水平均低于对照组,差异有统计学意义(P<0.05)。结论 VATS肺段与肺叶切除术在早期NSCLC的治疗中疗效无明细差异,肺段切除术能够改善病人肺功能,减轻炎症反应。

Objective To investigate that efficacy of video-assisted thoracoscopic surgery(VATS) and total video-assisted thoracoscopic lobectomy in the treatment of early-stage non-small cell lung canc(NSCLC) and the effects on serum inflame matory factor.Methods A total of 86 patients with early NSCLC who were treated in the thoracic surgery of Yibin Second People’s Hospital from January 2018 to January 2020 were selected and divided into the research group(n=45) of anatomic segmentectomy under VATS and the control group(n=41) of lobectomy under VATS according to the surgical method.The surgical effects and changes in pulmonary function indexes of the two groups were compared.The serum levels of C-reacive protein(CRP),interleukin-1β(IL-1β),interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) before and after treatment were detected.Results The operation time, intraoperative bleeding volume, postoperative drainage volume and postoperative drainage time in the research group were significantly higher than those in the control group(P<0.05).The hospital stay in the research group was significantly lower than that in the control group(P<0.05).There was no statistical difference in the number of lymph node cleanings between the two groups(P>0.05).Preoperative FEV1%,FVC% and PEF pulmonary function indexes showed no significant difference between the two groups(P>0.05).The percentages of FEV1% and FVC% after surgery in the two groups were significantly lower than those before surgery, and the PEF was significantly higher than that before surgery with statistical significance(P<0.05).The levels of FEV1%,FVC% and PEF in the postoperative study group were significantly higher than those in the control group(P<0.05).Serum CRP,IL-1β,IL-6,and TNF-α levels of the two groups on day 1 and day 3 after surgery were significantly higher than those before surgery(P<0.05).The levels of serum CRP,IL-1β,IL-6,and TNF-α on day 1 after surgery were significantly higher than those on day 3 after surgery(P<0.05).The levels of serum CRP,IL-1β,IL-6,and TNF-α in the study group were significantly lower than those in the control group 1 d and 3 d after surgery(P<0.05).Conclusion VATS anatomical segmentectomy in the treatment of early NSCLC can effectively improve lung function of patients and significantly reduce the body inflammatory response.