胸腔镜肺叶切除术对老年早期肺癌患者的临床效果及对氧化应激相关分子的影响

Clinical Effect of Thoracoscopic Lobectomy on Elderly Patients with Early Lung Cancer and Its Effect on Oxidative Stress Related Molecules

目的 探讨胸腔镜肺叶切除术对老年早期肺癌患者的治疗效果。方法 选取80例老年早期肺癌患者,依据随机数字表法划分成两组。对照组(40例)实施传统开胸手术,观察组(40例)实施胸腔镜肺叶切除术,两组均随访至术后3个月。对比两组手术相关指标、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)]、炎症因子水平[白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]、生活质量[生活质量综合评定问卷(GQOLI-74)中各维度评分]、并发症发生情况。结果 观察组术中出血量[(123.59±8.37)ml]少于对照组[(145.67±10.56)ml],手术与住院时间[(112.63±7.63)min、(8.21±1.57)d]短于对照组[(139.57±9.44)min、(10.94±2.36)d],有统计学差异(P<0.05);术后1 d,观察组SOD[(96.97±9.23)U/L]高于对照组[(85.64±8.44)U/L],MDA、IL-6、TNF-α、CRP[(10.53±1.79)μmol/L、(92.67±7.45)ng/L、(73.54±6.52)ng/L、(18.05±2.05)mg/L]低于对照组[(12.36±2.48)μmol/L、(103.75±8.71)ng/L、(82.69±7.21)ng/L、(25.67±2.78)mg/L],有统计学差异(P<0.05);术后3个月,观察组GQOLI-74内各维度评分[(80.26±4.13)分、(82.23±4.18)分、(83.67±4.28)分、(82.13±4.08)分]均高于对照组[(71.34±3.27)分、(73.15±3.57)分、(72.30±3.41)分、(71.39±3.18)分],有统计学差异(P<0.05);观察组并发症发生率[7.50%(3/40)]低于对照组[25.00%(10/40)],有统计学差异(P<0.05)。结论 胸腔镜肺叶切除术可有效减少术中出血量,缩短手术时间,减轻术后氧化应激反应与炎症反应,有利于患者术后恢复及生活质量提升,且并发症较少,临床可进行大力推行。

Objective To explore the therapeutic effect of thoracoscopic lobectomy in elderly patients with early lung cancer.Methods 80 elderly patients with early lung cancer diagnosed and treated were divided into 2 groups according to the random number table method.The control group(40 cases) underwent traditional thoracotomy, and the observation group(40 cases) underwent thoracoscopic lobectomy.Three months after operation were observed in both groups.The operation related indexes, oxidative stress indexes [superoxide dismutase(SOD),malondialdehyde(MDA)],inflammatory factor levels [interleukin-6(IL-6),tumor necrosis factor] were compared between the 2 groups-α(TNF-α)、 C-reactive protein(CRP),quality of life [scores of all dimensions in the comprehensive quality of life assessment questionnaire(GQOLI-74)],complications.Results the intraoperative blood loss in the observation group [(123.59±8.37)ml] was less than that in the control group [(145.67±10.56)ml],and the operation and hospitalization time [(112.63±7.63)min,(8.21±1.57)D] were shorter than that in the control group [(139.57±9.44)min,(10.94±2.36)d],with statistical difference(P<0.05);One day after operation, sod[(96.97±9.23)U/l] in the observation group was higher than that in the control group [(85.64±8.44)U/l],MDA,IL-6,TNF-α、 CRP[(10.53±1.79)μ Mol/l,(92.67±7.45)ng/l,(73.54±6.52)ng/l,(18.05±2.05)mg/l] was lower than that of the control group [(12.36±2.48)μ Mol/l,(103.75±8.71)ng/l,(82.69±7.21)ng/l,(25.67±2.78)mg/l],with statistical difference(P<0.05);Three months after operation, the scores of GQOLI-74 in the observation group [(80.26±4.13),(82.23±4.18),(83.67±4.28),(82.13±4.08)] were significantly higher than those in the control group [(71.34±3.27),(73.15±3.57),(72.30±3.41),(71.39±3.18)](P<0.05);The incidence of complications in the observation group [7.50%(3/40)] was lower than that in the control group [25.00%(10/40)],with statistical difference(P<0.05).Conclusion thoracoscopic lobectomy can effectively reduce the amount of intraoperative bleeding, shorten the operation time, reduce the postoperative oxidative stress reaction and inflammatory reaction, and is conducive to the postoperative recovery and quality of life improvement of patients.With fewer complications, it can be vigorously promoted in clinical practice.