单操作孔VATS在早期肺癌患者中的应用效果

Application effect of single-hole VATS in patients with early lung cancer

ax目的探讨单操作孔电视胸腔镜手术(VATS)对早期肺癌患者术后免疫、炎症反应及并发症发生情况的影响。方法选取我院2015年1月至2018年3月收治的120例早期肺癌患者作为研究对象,根据随机数字表法将其分为观察组和对照组,各60例。观察组采取单操作孔VAST+淋巴结清扫术,对照组采取三孔VAST+淋巴结清扫术。比较两组的临床疗效、血清肿瘤标志物水平、手术相关指标、免疫及炎症指标、肺功能指标、并发症发生情况。结果两组的治疗总有效率比较,差异无统计学意义(P>0.05)。术后,两组的癌抗原125(CA125)、癌抗原153(CA153)、癌胚抗原(CEA)水平均显著降低,且观察组低于对照组(P<0.05)。观察组的手术时间长于对照组,术中出血量少于对照组,术后置管时间、住院时间短于对照组(P<0.05)。术后7 d,观察组的C反应蛋白(CRP)水平、白细胞计数(WBC)及中性粒细胞比例低于对照组(P<0.05)。术后,观察组的动脉血氧分压(PaO_(2))、第1秒用力呼气容积占用力肺活量的比值(FEV_(1)/FVC)、肺活量(VC)均高于对照组(P<0.05)。两组的并发症总发生率比较,差异无统计学意义(P>0.05)。结论相比于三孔VATS,单操作孔VATS治疗早期肺癌患者的效果更优,对患者的损伤小,可改善血清肿瘤标志物水平及免疫、炎症、肺功能指标,利于机体恢复。

Objective To investigate the effect of single-hole video-assisted thoracic surgery(VATS)on postoperative immune,inflammatory response and occurrence of complications in patients with early lung cancer.Methods A total of120 patients with early lung cancer admitted in our hospital from January 2015 to March 2018 were selected as the research objects.According to the random number table method,the patients were divided into observation group and control group,with 60 cases in each group.The observation group was treated with single-hole VAST+lymph node dissection,and the control group was treated with three-hole VAST+lymph node dissection.The clinical efficacy,serum tumor markers levels,surgery-related indicators,immune and inflammatory indicators,lung function indicators and occurrence of complications were compared between the two groups.Results There was no significant difference in the total effective rate of treatment between the two groups(P>0.05).After operation,the levels of cancer antigen 125(CA125),cancer antigen 153(CA153)and carcinoembryonic antigen(CEA)in the two groups significantly decreased,and those in the observation group were lower than the control group(P<0.05).The operation time of the observation group was longer than that of the control group,the intraoperative blood loss was less than that of the control group,and the postoperative catheterization time and hospitalization time were shorter than those of the control group(P<0.05).At 7 d after operation,the levels of C-reactive protein(CRP),white blood cell count(WBC)and proportion of central granulocytes in the observation group were lower than those in the control group(P<0.05).After operation,the arterial partial pressure of oxygen(PaO_(2)),ratio of forced expiratory volume in the first second to forced vital capacity(FEV_(1)/FVC)and vital capacity(VC)in the observation group were higher than those in the control group(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Compared with three-hole VATS,single-hole VATS is more effective in the treatment of patients with early lung cancer.It has less damage to patients,and can improve serum tumor marker levels and immune,inflammatory and lung function indicators,which is conducive to body recovery.