完全电视胸腔镜肺段与肺叶切除术治疗早期肺癌的临床疗效研究

Clinical efficacy of complete video-assisted thoracoscopic segmental and lobectomy in the treatment of early lung cancer

目的探讨完全电视胸腔镜手术(VATS)治疗早期肺癌的疗效及安全性。方法回顾性分析2021年1月至2021年12月于本院行VATS的患者74例的临床资料,依据手术方式不同,分为肺段切除组(37例,行VATS肺段切除术)与肺叶切除组(37例,行VATS肺叶切除术),所有患者术中均接受相应护理干预措施。术后3个月,比较两组手术指标、术前与术后肺功能指标[包括最大通气量(MVV)、用力肺活量(FVC)及第1秒钟用力呼气量与用力肺活量比值(FEV1%)]、皮肤受伤程度及并发症发生率。结果两组患者术后引流量、淋巴结清扫数相比,差异无统计学意义(P>0.05);肺段切除组患者的手术时间明显长于肺叶切除组,术中出血量、住院时间明显少/短于肺叶切除组,差异有统计学意义(P<0.05);术前,两组MVV、FVC、FEV1%水平相比,差异无统计学意义(P>0.05);术后,肺段切除组MVV、FVC、FEV1%水平明显高于肺叶切除组,差异有统计学意义(P<0.05);肺段切除组皮肤无反应率高于肺叶切除组,差异有统计学意义(P<0.05);肺段切除组并发症发生率低于肺叶切除组,但差异无统计学意义(P>0.05)。结论完全电视胸腔镜肺段切除手术治疗早期肺癌可缩短住院时间、降低术中出血量、减轻皮肤受伤程度,且能降低手术对患者肺功能的影响,同时安全性较高,值得推广应用。

Objective To investigate the efficacy and safety of VATS in the treatment of early lung cancer.Methods The clinical data of 74 patients who underwent VATS in our hospital from January 2021 to December 2021 were retrospectively analyzed,according to different surgical methods,they were divided into segmental pneumonectomy group(37 patients,VATS segmental pneumonectomy)and lobectomy group(37 patients,VATS lobectomy).All patients received corresponding nursing intervention measures during operation.Three months after operation,the operation indexes,preoperative and postoperative lung function indexes[including maximum ventilation volume(MVV),forced vital capacity(FVC)and the ratio of forced expiratory volume to forced vital capacity in one second(FEV1%)],skin injury degree and complication rate of the two groups were compared.Results There was no significant difference between the two groups in postoperative drainage volume and lymph node clearance(P>0.05).The operation time of patients in the segmental resection group was significantly longer than that in the lobectomy group,and the amount of intraoperative bleeding and hospital stay were significantly less/shorter than that those in the lobectomy group(P<0.05).Before operation,there was no significant difference in MVV,FVC and FEV1%between the two groups(P>0.05).After operation,the levels of MVV,FVC and FEV1%in segmental resection group were significantly higher than those in lobectomy group(P<0.05).The skin non-reaction rate of segmental pneumonectomy group was higher than that of lobectomy group(P<0.05).The incidence of complications in segmental resection group was lower than that in lobectomy group,but the difference was not statistically significant(P>0.05).Conclusion Complete video-assisted thoracoscopic segmental resection for early lung cancer can shorten hospital stay,reduce intraoperative bleeding,reduce the degree of skin injury,and reduce the impact of surgery on lung function of patients,at the same time,it is safe and worth popularizing.