胸腔镜手术治疗非小细胞肺癌的临床疗效及对患者血清肿瘤标志物水平的影响

Efficacy of thoracoscopic surgery in the treatment of non-small cell lung cancer and its effect on serum tumor marker levels in patients

目的探讨胸腔镜手术治疗非小细胞肺癌(NSCLC)的临床疗效及对患者血清肿瘤标志物水平的影响。方法选取2018年5月至2020年6月本院收治的80例NSCLC患者作为研究对象,采用随机数字表法分为对照组与观察组,每组40例。对照组行三孔胸腔镜肺叶切除术治疗,观察组行单孔胸腔镜肺叶切除术治疗,比较两组临床指标、肿瘤标志物水平、肺功能及并发症发生率。结果观察组住院时间短于对照组,术中出血量少于对照组,术后24 h时视觉模拟评分法(VAS)评分低于对照组,差异有统计学意义(P<0.05);两组引流管留置时间、手术时间及术后卧床时间比较差异无统计学意义。术后,两组血清癌胚抗原(CEA)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)及糖类抗原50(CA50)水平均低于术前,差异有统计学意义(P<0.05),但两组间血清CEA、CYFRA21-1、CA50水平比较差异无统计学意义。观察组并发症发生率为5.00%,略低于对照组的15.00%,但差异无统计学意义。结论单孔胸腔镜肺叶切除术与三孔胸腔镜肺叶切除术治疗NSCLC患者均有一定临床疗效,可降低肿瘤标志物水平,但单孔胸腔镜肺叶切除术可缩短住院时间,减少术中出血量,缓解患者术后疼痛,可有效促进患者术后恢复,且并发症较少,值得临床推广应用。

Objective To investigate the effect of thoracoscopic surgery in the treatment of non-small cell lung cancer(NSCLC)and its effect on serum tumor markers levels in patients.Methods 80 patients with NSCLC admitted to our hospital from May 2018 to June 2020 were selected as the research subjects,and they were divided into the control group and the observation group according to random number table method,with 40 cases in each group.The control group was treated with three-hole thoracoscopic lobectomy,while the observation group was treated with single-hole thoracoscopic lobectomy,the clinical indexes,tumor marker levels,lung function and the incidence of complications were compared between the two groups.Results The hospitalization time of the observation group was shorter than that of the control group,the intraoperative blood loss was less than that of the control group,and the visual analogue scale(VAS)score at 24 h after operation was lower than that of the control group,and the difference was statistically significant(P<0.05);there was no significant difference in drainage tube indwelling time,operation time and postoperative bed rest time between the two groups.After operation,the levels of serum carcinoembryonic antigen(CEA),cyto-keratin 19 fragment antigen 21-1(CYFRA21-1)and carbohydrate antigen 50(CA50)in the two groups were lower than those before operation,and the difference was statistically significant(P<0.05),but there was no significant difference in the levels of serum CEA,CYFRA21-1 and CA50 between the two groups.The incidence of complications in the observation group was 5.00%,which was slightly lower than 15.00%in the control group,but the difference was not statistically significant.Conclusion Single-hole thoracoscopic lobectomy and three-hole thoracoscopic lobectomy in the treatment of patients with NSCLC have certain clinical curative effects,which can reduce the level of tumor markers,but single-hole thoracoscopic lobectomy can shorten the length of hospital stay,less intraoperative blood loss,postoperative pain relieve patients,can effectively promote the patients with postoperative recovery,and less complications,which is worthy of clinical popularization and application.