单孔胸腔镜肺癌根治术与传统三孔法胸腔镜手术治疗肺癌的临床效果对比

Comparison of Clinical Effects between Single Hole Thoracoscopic Radical Resection of Lung Cancer and Traditional Three Hole Thoracoscopic Surgery for the Treatment of Lung Cancer

目的:对比单孔胸腔镜肺癌根治术与传统三孔法胸腔镜手术治疗肺癌的临床效果。方法:将2019年3月—2021年12月赤壁市人民医院筛选入组的300例肺癌患者以信封法分为对照组(n=150)和研究组(n=150)。对照组实施传统三孔法胸腔镜手术治疗,研究组实施单孔胸腔镜肺癌根治术。对比两组手术相关指标、疼痛相关指标、免疫功能相关指标及并发症发生情况。结果:研究组术后24 h引流量少于对照组,引流管留置时间短于对照组,手术时间长于对照组,差异有统计学意义(P<0.05);两组术中出血量比较差异无统计学意义(P>0.05)。手术后24 h,两组血清多巴胺(DA)、去甲肾上腺素(NE)、5-羟色胺(5-HT)较手术前增加,但研究组低于对照组,差异有统计学意义(P<0.05)。手术后3 d,研究组CD4^(+)、CD3^(+)及CD4^(+)/CD8^(+)均较手术前降低,且研究组上述指标均高于对照组,差异有统计学意义(P<0.05)。研究组并发症发生率为6.00%,与对照组的7.33%比较,差异无统计学意义(χ^(2)=0.214,P=0.643)。结论:单孔胸腔镜肺癌根治术相较于三孔法胸腔镜手术更能改善手术相关指标,减轻疼痛程度,对免疫功能影响较低,且不增加并发症发生率。

Objective:To compare the clinical effects of single hole thoracoscopic radical resection of lung cancer and traditional three hole thoracoscopic surgery for lung cancer.Method:A total of 300 lung cancer patients screened from Chibi People's Hospital from March 2019 to December 2021 were divided into control group(n=150)and study group(n=150)by envelope method.The control group underwent traditional three hole thoracoscopic surgery,while the study group underwent single hole thoracoscopic radical surgery of lung cancer.The surgery related indexes,pain related indexes,immune function related indexes and complications were compared between the two groups.Result:The 24 h postoperative drainage volume of the study group was less than that of the control group,the indwelling time of drainage tube was shorter than that of the control group,and the operative time was longer than that of the control group,the differences were statistically significant(P<0.05),there was no significant difference in intraoperative blood loss between the two groups(P>0.05).At 24 h after surgery,the serum levels of dopamine(DA),norepinephrine(NE),and serotonin(5-HT)in both groups were increased compared with that before surgery,but the study group were lower than the control group,the differences were statistically significant(P<0.05).At 3 d after surgery,CD4^(+),CD3^(+)and CD4^(+)/CD8^(+)in the study group were lower than before surgery,and the above indexes in the study group were higher than those in the control group,the differences were statistically significant(P<0.05).The complication rate in the study group was 6.00%,which was not statistically significant compared with 7.33%in the control group(χ^(2)=0.214,P=0.643).Conclusion:Compared to the three hole thoracoscopic surgery,the single hole thoracoscopic radical resection of lung cancer can improve surgical related indicators,reduce pain,have a lower impact on immune function,and do not increase the incidence of complications.