胸腔镜下肺段切除术治疗双肺部小结节的临床疗效分析

Clinical Efficacy Analysis of Thoracoscopic Segmentectomy in Treatment of Bilateral Pulmonary Nodule

目的:比较胸腔镜下肺段切除与肺叶切除治疗双肺部小结节的临床疗效及对肺功能指标的影响。方法:选取2020年1月-2022年1月解放军总医院第八医学中心收治的肺部小结节患者100例为观察对象,以病理检出结果不同分为观察组和对照组,各50例。对照组在胸腔镜下开展肺叶切除术,观察组在胸腔镜下进行肺段切除术。比较两组患者手术指标、肺功能和并发症发生率。结果:观察组平均出血量、平均引流量少于对照组,平均引流用时间、住院时间短于对照组,差异有统计学意义(P<0.05);治疗后,观察组用力肺活量、第1秒用力呼气容积、最大自主通气量指数均高于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:胸腔镜模式下肺段切除术治疗双肺部小结节的效果相比于肺叶切除术更佳,可明显改善患者手术指标,且可更好地保护肺功能,安全性较高。

Objective:To compare the clinical efficacy of thoracoscopic segmentectomy and lobectomy in treatment of bilateral pulmonary nodule and its effect on pulmonary function indexes.Methods:From January 2020 to January 2022,100 patients with small pulmonary nodules who were treated in the Eighth Medical Center of Chinese PLA General Hospital were selected as the observation objects and divided into observation group and control group according to different pathology detection results,with 50 cases in each group.The control group underwent lobectomy under thoracoscopy,and the observation group underwent segmentectomy under thoracoscopy.The surgery indicators,pulmonary function and the incidence of complications in two groups were compared.Results:In the observation group,the average blood loss and average drainage volume were less than those in the control group,and the mean drainage time and hospital stay were shorter than those in the control group,and the differences were statistically significant(P<0.05);After treatment,the forced vital capacity index,forced expiratory volume in the first second,and maximal voluntary ventilation of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05);There was no significant difference in the incidence of complications between two groups(P>0.05).Conclusion:The effect of segmentectomy under thoracoscopic mode is better than that of lobectomy in the treatment of bilateral pulmonary nodules,and it can better improve surgery indicators,stabilize lung function and has high safety.