保留迷走神经肺支对胸腔镜上叶肺癌根治术后咳嗽的影响:前瞻性随机对照研究

Effect of preserving pulmonary branch of vagus nerve on cough after thoracoscopic radical resection of upper lobe lung cancer: Prospective randomized controlled study

目的 探讨胸腔镜上叶肺癌根治术中保留迷走神经肺支是否减轻术后咳嗽的发生。方法 采用前瞻性、随机对照研究,对我科2019年3月至2021年3月胸腔镜上叶肺癌根治术120例患者,按手术方式分为保留迷走神经肺支组(保迷组)和切断迷走神经肺支组(传统组),每组各60例,应用莱斯特咳嗽量表中文版(The Leicester Cough Questionnaire in Mandarin-Chinese, LCQ-MC)从生理、心理和社会3个维度分析比较患者术前、术后咳嗽情况。结果 术后两组患者生理、心理、社会维度的LCQ-MC评分均较术前降低,均出现咳嗽症状。保迷组患者术后生理、心理、社会维度的LCQ评分均优于传统组,咳嗽情况有所减轻(P<0.05)。结论 胸腔镜上叶肺癌根治术中保留迷走神经肺支可减轻术后咳嗽的发生,对于患者加速康复具有重要作用,是安全、可行的。

Objective To investigate the effect of preserving the pulmonary branch of vagus nerve on cough after the thoracoscopic radical resection of upper lobe lung cancer.Methods A prospective, randomized and controlled study was carried out.A total of 120 lung cancer patients were selected in this study from March 2019 to March 2021 in Fuzhou Pulmonary Hospital of Fujian according to the adoption standardization.The patients were divided into two groups: traditional operation group and the group of reserving the pulmonary branch of vagus nerve.The clinical data was analyzed between the two groups by Mandarin Chinese Version of the Leicester Cough Questionnaire(LCQ-MC).Results The preoperative score of LCQ-MC was significantly higher than postoperative score, and different degrees of cough were found in the two groups.The postoperative score of LCQ-MC was significantly higher in the group of reserving the vagus nerve than that in the traditional operation group, and cough was relieved in the preservation group(P<0.01).Conclusion Preserving the pulmonary branch of vagus nerve during thoracoscopic radical resection of upper lobe lung cancer can reduce the incidence of cough after surgery.It is a safe and feasible surgical method, which play a very important role in enhanced recovery after surgery.