单孔胸腔镜手术在老年肺结节患者治疗中应用的效果分析

The Effects of Single Hole Thoracoscopy Surgery in the Treatment of Elderly Patients with Pulmonary Nodules

目的 分析单孔胸腔镜与多孔胸腔镜在老年肺结节患者治疗中应用的效果。方法 将我院2021年1月至2023年2月收治的114例老年肺结节患者作为研究对象,用随机数字表将患者分为对照组与观察组,对照组57例,行常规多孔胸腔镜手术治疗,观察组57例,行单孔胸腔镜手术治疗。比较两组患者围手术期各项指标、术前和术后肺功能指标、治疗效果(显效率+有效率)及并发症发生率。结果 两组患者手术时间对比无明显差异(P=0.494),观察组患者术中出血量和术后引流量低于对照组、住院时间短于对照组(均P <0.001);术前两组患者肺功能指标水平对比无差异(P> 0.05),术后观察组患者第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、每分钟最大通气量(MVV)、FEV_(1)/FVC均高于对照组(均P <0.001);观察组治疗总有效率高于对照组(98.25%vs.85.96%,P=0.037);观察组患者并发症发生率低于对照组(1.75%vs.15.79%,P=0.020)。结论 相比常规多孔胸腔镜手术,单孔胸腔镜手术在老年肺结节患者治疗中应用效果更佳,能减少患者术中出血量和术后引流量,加快患者康复的速度,改善患者肺功能指标,降低并发症发生率,但二者手术时间无明显差异。

Objective To analyze the effectiveness of single hole thoracoscopy and multi hole thoracoscopy in the treatment of elderly patients with pulmonary nodules.Methods This study enrolled 114 elderly patients with pulmonary nodules admitted to the People's Hospital of Liyang City,Jiangsu Province from January 2021 to February 2023.The patients were randomly divided into control group and observation group using a random number table,with 57 patients in each group.The conventional multi-hole thoracoscopy surgery was used in control group,and single hole thoracoscopy surgery was used in observation group.The perioperative indicators,preoperative and postoperative lung function,treatment effectiveness,and incidence of complications between two groups were compared.Results There was no significant difference in surgical time between the two groups(P=0.494).The intraoperative bleeding volume and postoperative drainage volume of the observation group were lower than those of the control group(all P<0.001),and the hospital stay was shorter than that of the control group(all P<0.05).There was no difference in lung function indicators between the two groups(P>0.05).The postoperative FEV_1,FVC,MVV,and FEV_1/FVC in the observation group were higher than those in the control group(all P<0.05).The total effective rate of the observation group was higher than that of the control group(98.25% vs 85.96%,P=0.037);The incidence of complications in the observation group was lower than that in the control group(1.75% vs.15.79%,P=0.020).Conclusions Comparing multi-hole thoracoscopy surgery,single hole thoracoscopic surgery in the treatment of elderly patients with pulmonary nodules had a better efficacy,can reduce intraoperative bleeding and postoperative drainage volume,improve lung function indicators,and reduce the incidence of complications,but there is no significant different in the duration of the surgical time between the two.