单孔胸腔镜肺切除术治疗早期肺癌的效果及对肿瘤标志物水平的影响

The Effect of Single Hole Thoracoscopy Pneumonectomy in the Treatment of Early Stage Lung Cancer and Its Influence on the Levels of Tumor Markers

目的:探讨单孔胸腔镜肺切除术治疗早期肺癌的效果及对肿瘤标志物水平的影响。方法:选取苏州市中医医院2020年7月—2022年12月收治的116例早期肺癌患者,根据手术方式将其分为单孔组和两孔组,每组58例。单孔组采用单孔胸腔镜肺切除术,两孔组采用两孔胸腔镜肺切除术。对比两组手术效果、疼痛评分、肿瘤标志物水平及并发症发生率。结果:两组手术时间、淋巴结清扫数对比,差异均无统计学意义(P>0.05)。单孔组术中出血量少于两孔组,术后引流时间、住院时间均短于两孔组,差异均有统计学意义(P<0.05)。术后24 h、3 d和出院时,单孔组疼痛评分均低于两孔组,差异均有统计学意义(P<0.05)。术后24 h,单孔组可溶性细胞角蛋白19片段(Cyfra21-1)、糖类抗原125(CA125)、癌胚抗原(CEA)均低于两孔组,差异均有统计学意义(P<0.05)。两组并发症发生率对比,差异无统计学意义(P>0.05)。结论:与两孔胸腔镜肺切除术治疗早期肺癌相比,单孔胸腔镜肺切除术手术效果更好,可减少手术创伤,缓解术后疼痛,降低肿瘤标志物水平,促进患者术后恢复,且不会增加术后并发症发生率,安全可靠。

Objective:To explore of the effect of single hole thoracoscopy pneumonectomy in the treatment of early stage lung cancer and its influence on the levels of tumor markers.Method:A total of 116 early stage lung cancer patients admitted to Suzhou Hospital of Traditional Chinese Medicine from July 2020 to December 2022 were selected,they were divided into a single hole group and a two holes group based on the surgical method,with 58 cases in each group.The single hole group underwent single hole thoracoscopic pneumonectomy,while the two holes group underwent two holes thoracoscopic pneumonectomy.The surgical effects,pain scores,tumor marker levels,and incidence of complications were compared between the two groups.Result:There were no statistically significant differences in surgical time and the number of lymph node dissection between the two groups(P>0.05).The intraoperative bleeding volume in the single hole group was less than that in the two holes group,and the postoperative drainage time and hospitalization time were shorter than those in the two holes group,the differences were statistically significant(P<0.05).At 24 hours,3 days,and upon discharge,the pain scores in the single hole group were lower than those in the two holes group,the differences were statistically significant(P<0.05).At 24 h after operation,the soluble cell keratin 19 fragment(Cyfra21-1),carbohydrate antigen 125(CA125)and carcinoembryonic antigen(CEA)in the single hole group were lower than those in the two holes groups,the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Compared with two holes thoracoscopic pneumonectomy for the treatment of early stage lung cancer,single hole thoracoscopic pneumonectomy has a better surgical effect,can reduce surgical trauma,alleviate postoperative pain,lower tumor marker levels,promote postoperative recovery,and do not increase the incidence of postoperative complications,it is safe and reliable.