胸腔镜下肺段切除在早期非小细胞肺癌患者中的应用研究

Study on the Application of Thoracoscopic Pulmonary Segmental Resection in Patients with Early-stage Non-small Cell Lung Cancer

目的 探讨胸腔镜下肺段切除在早期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者中的应用效果。方法 回顾性选取2016年1月—2021年12月泰州市第二人民医院收治的早期NSCLC患者70例,按照随机数表法对其分为对照组与研究组,每组35例。对照组行胸腔镜下肺叶切除术,研究组应用胸腔镜下肺段切除术。比较两组围术期指标、手术前后肺功能[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)与最大通气量(MVV)],以及术后并发症发生情况。结果 研究组手术时间(159.65±6.02)min较对照组(150.36±5.78)min更长,胸腔引流量(440.20±32.52)mL较对照组(510.65±40.48)mL更少,住院时间(6.02±0.48)d较对照组(7.86±0.50)d更短,差异有统计学意义(t=6.586、8.027、15.705,P<0.05),研究组术中失血量(155.02±3.52)mL、淋巴结清扫个数(4.02±0.58)个与对照组(156.66±4.02)mL、(4.03±0.75)个比较,差异无统计学意义(t=1.816、0.062,P>0.05)。术后研究组FEV1(79.52±5.56)%、FVC(86.65±5.02)%、MVV(78.65±7.05)%较对照组(65.65±4.85)%、(70.35±6.78)%、(65.68±6.45)%均更高,差异有统计学意义(t=11.122、11.431、8.030,P<0.05)。研究组术后并发症为2.86%与对照组的8.57%比较,差异无统计学意义(χ^(2)=0.265,P>0.05)。结论 相较于胸腔镜下肺叶切除术,胸腔镜肺段切除术对于早期NSCLC患者肺功能的影响更小,且缩短了康复进程。

Objective To investigate the effect of thoracoscopic pulmonary segmental resection in patients with earlystage non-small cell lung cancer(NSCLC).Methods Retrospective selection of 70 subjects involved in the study were all early-stage NSCLC patients admitted to Taizhou Second People's Hospital from January 2016 to December 2021,and they were divided into control group and study group according to the random number table methhod,and 35 cases in each group.The control group underwent thoracoscopic lobectomy,and the study group applied thoracoscopic pulmonary segmental resection.Perioperative indicators,preoperative and postoperative pulmonary function[force expiratory volume at 1s(FEV1),forced vital capacity(FVC)and maximum ventilation volume(MVV)],and postoperative occurrence of complications were compared between the two groups.Results The operative time in the study group was(159.65±6.02)minutes longer than that in the control group(150.36±5.78)minutes,and the chest drainage volume(440.20±32.52)mL was were less than the control group(510.65±40.48)mL,and hospital stay(6.02±0.48)dshorter than the control group(7.86±0.50)d,the differences were statistically significant(t=6.586,8.027,15.705,P<0.05).The intraoperative blood loss(155.02±3.52)mL and number of lymph nodes cleared(4.02±0.58)were not statistically significant in the study group compared with(156.66±4.02)mL and(4.03±0.75)in the control group(t=1.816,0.062,P>0.05).Postoperatively,FEV1(79.52±5.56)%,FVC(86.65±5.02)%,and MVV(78.65±7.05)%were higher in the study group compared to the control group(65.65±4.85)%,(70.35±6.78)%,and(65.68±6.45)%,the difference was statistically significant(t=11.122,11.431,8.030,P<0.05).The postoperative complications in the study group were 2.86%,compared with 8.57%in the control group,the difference was not statistically significant(χ^(2)=0.265,P>0.05).Conclusion Compared with thoracoscopic lobectomy,thoracoscopic segmental pulmonary resection has less impact on the lung function of patients with early NSCLC and shortens the recovery process.