胸腔镜下肺亚段切除术治疗早期肺癌患者的临床效果

Clinical Effect of Pulmonary Subsegment Resection under Thoracoscopy in the Treatment of Patients with Early Lung Cancer

目的:探讨胸腔镜下肺亚段切除术治疗早期肺癌患者的临床效果。方法:回顾性分析2022年3月—2023年3月福建医科大学附属第二医院收治的94例早期肺癌患者的临床资料。根据不同手术方式将其分为对照组(n=45)和观察组(n=49)。观察组给予胸腔镜下肺亚段切除术,对照组给予胸腔镜下肺段切除术。比较两组围手术期指标,术前和术后1 d、3 d炎症因子及并发症。结果:两组手术时间、术中出血量、病灶切缘宽度、住院时间比较,差异无统计学意义(P>0.05),观察组切除亚段数少于对照组,差异有统计学意义(P<0.05)。术后1 d、3 d,两组C反应蛋白(CRP)、降钙素原(PCT)水平均高于术前,术后3 d,两组CRP、PCT水平低于术后1 d,观察组CRP、PCT水平均低于对照组,差异有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:胸腔镜下肺段切除术与胸腔镜下肺亚段切除术治疗早期肺癌手术效果相当,但胸腔镜下肺亚段切除术可减少切除亚段数目,减轻术后短期内炎症反应。

Objective:To explore the clinical effect of pulmonary subsegment resection under thoracoscopy in the treatment of patients with early lung cancer.Method:The clinical data of 94 patients with early lung cancer admitted to the Second Affiliated Hospital of Fujian Medical University from March 2022 to March 2023 were retrospectively analyzed.They were divided into control group(n=45)and observation group(n=49)according to different surgical methods.The observation group received pulmonary subsegment resection under thoracoscopy,and the control group received pulmonary segment resection under thoracoscopy.Perioperative indexes,inflammatory factors before and 1 d,3 d after surgery and complications were compared between the two groups.Result:There were no significant differences in surgery time,intraoperative blood loss volume,lesion incisal margin width,and hospital stay between the two groups(P>0.05).The number of resection subsegments in the observation group was less than that in the control group,and the difference was statistically significant(P<0.05).At 1 d and 3 d after surgery,the levels of C-reactive protein(CRP)and procalcitonin(PCT)in the two groups were higher than those before surgery,3 d after surgery,CRP and PCT levels in both groups were lower than 1 d after surgery,and the levels of CRP and PCT in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:The surgery effect of pulmonary segmental resection under thoracoscopy and pulmonary subsegment resection under thoracoscopy is equivalent in the treatment of early lung cancer.However,pulmonary subsegment resection under thoracoscopy can reduce the number of resected subsegments and alleviate short-term inflammatory reactions after surgery.