全腔镜解剖性肺段切除术对早期非小细胞肺癌患者肺功能及术后并发症的影响

The Effect of Total Endoscopic Anatomical Segmental Resection on Lung Function and Postoperative Complications in Early Non-small Cell Lung Cancer Patients

目的探讨全腔镜解剖性肺段切除术对早期非小细胞肺癌(NSCLC)患者中的治疗效果。方法选取100例早期NSCLC患者,依照随机数字表法划分成两组,均为50例。对照组给予全腔镜肺叶切除术,观察组予以全腔镜解剖性肺段切除术,观察到术后3个月。对比两组手术相关指标、肺功能、生活质量、并发症。结果观察组手术时间[(165.78±18.21)min]长于对照组,术中出血量[(165.44±19.21)ml]、胸腔引流量[(143.21±15.38)ml]少于对照组,住院时间[(6.38±1.21)d]短于对照组,有统计学差异(P<0.05);术前两组呼气流量峰值(PEF)、第1秒用力呼气量(FEV1)、用力肺活量(FVC)与生活质量综合评定问卷(GQOLI-74)内各维度评分相比,无统计学差异(P>0.05);术后3个月,观察组PEF[(3.58±0.65)L/s]、FEV1[(2.09±0.41)L]、FVC[(3.06±0.58)L]与GQOLI-74各维度评分[(78.43±4.36)分、(81.29±4.68)分、(80.67±4.35)分、(78.61±4.28)分]均高于对照组,有统计学差异(P<0.05);两组并发症发生率相比,无统计学差异(P>0.05)。结论全腔镜解剖性肺段切除术在早期NSCLC患者治疗中效果确切,虽手术时间较长,但可较多保存患者健康肺组织,缩减出血量、胸腔引流量,缩短住院时间,改善其生活质量,且并发症更少,安全可靠,值得临床的大力推广。

Objective To explore the therapeutic effect of total endoscopic anatomical segmental resection for early non-small cell lung cancer(NSCLC)patients.Methods 100 early NSCLC patients were selected and divided into 2 groups according to the random number table method,with 50 cases in both groups.The control group received total endoscopic pulmonary lobectomy,while the observation group received total endoscopic anatomical segmental resection.The postoperative period was 3 months.Compare the surgical related indicators,lung function,quality of life,and complications between the 2 groups.Results The surgical time of the observation group[(165.78±18.21)minutes]was longer than that of the control group,and the intraoperative blood loss[(165.44±19.21)ml]and thoracic drainage flow[(143.21±15.38)ml]were lower than those of the control group.The hospital stay[(6.38±1.21)days]was shorter than that of the control group,with a statistical difference(P<0.05);There was no statistical difference between the scores of peak expiratory flow(PEF),forced expiratory volume in the first second(FEV1),forced vital capacity(FVC)and the scores of each dimension in the comprehensive quality of life questionnaire(GQOLI-74)between the 2 groups before surgery(P>0.05);3 months after surgery,the scores of PEF[(3.58±0.65)L/s],FEV1[(2.09±0.41)L],FVC[(3.06±0.58)L],and GQOLI-74 in all dimensions[(78.43±4.36)points,(81.29±4.68)points,(80.67±4.35)points,and(78.61±4.28)points]in the observation group were higher than those in the control group,with statistical differences(P<0.05);There was no statistically significant difference in the incidence of complications between the 2 groups(P>0.05).Conclusion Thoracoscopic anatomical segmental resection of the lung is effective in the treatment of early NSCLC patients.Although the surgical time is relatively long,it can preserve more healthy lung tissue,reduce bleeding volume,pleural drainage volume,shorten hospitalization time,improve their quality of life,and have fewer complications.It is safe and reliable,and is worthy of clinical promotion.