微创肺叶切除术和肺段切除术治疗非小细胞肺癌的安全性及对患者免疫功能、肺功能的影响

Safety of minimally invasive lobectomy and segmentectomy for non-small cell lung cancer and its impact on immune function and lung function

目的探究非小细胞肺癌通过微创肺叶切除术和肺段切除术治疗的临床效果。方法82例非小细胞肺癌患者,应用随机数字表法分成对照组与观察组,每组41例。对照组实施微创肺叶切除术治疗,观察组实施微创肺段切除术治疗。对比两组并发症发生情况、肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、第1秒用力呼气容积与用力肺活量的比值(FEV1/FVC)]、免疫功能指标[CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、自然杀伤细胞(NK)]。结果观察组并发症发生率比对照组低,但差异不显著(P>0.05)。术前,两组FVC、FEV1、FEV1/FVC比较,差异不明显(P>0.05);术后,观察组FVC(2.79±0.19)L、FEV1(2.15±0.21)L、FEV1/FVC(52.56±4.28)%均比对照组的(2.34±0.26)L、(1.98±0.17)L、(40.29±3.58)%更优,差异明显(P<0.05)。术前,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)以及NK比较,差异不显著(P>0.05);术后,观察组CD3^(+)(45.15±2.62)%、CD4^(+)(34.66±2.22)%、CD4^(+)/CD8^(+)(1.39±0.24)以及NK(19.58±1.52)%均比对照组的(30.48±2.82)%、(28.23±2.14)%、(1.25±0.22)、(18.26±1.53)%更优,差异显著(P<0.05)。结论微创肺叶切除术和肺段切除术治疗对非小细胞肺癌均有良好疗效,且安全性较高,但微创肺段切除术治疗更有助于改善患者免疫功能及肺功能,值得推广。

Objective To explore the clinical effect of minimally invasive lobectomy and segmentectomy for non-small cell lung cancer.Methods 82 patients of non-small cell lung cancer were divided into an observation group and a control group according to random numerical table,with 41 cases in each group.The control group was treated with minimally invasive lobectomy,and the observation group was treated with minimally invasive segmentectomy.Both groups were compared in terms of incidence of complications,pulmonary function indicators[forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC],and immune function indicators[CD3^(+),CD4^(+),CD4^(+)/CD8^(+),natural killer cells(NK)].Results The complication rate of the observation group was lower than that of the control group,but the difference was not significant(P>0.05).Before surgery,there were no significant differences in FVC,FEV1 and FEV1/FVC between the two groups(P>0.05).After surgery,the observation group had FVC of(2.79±0.19)L,FEV1 of(2.15±0.21)L,FEV1/FVC of(52.56±4.28)%,which were better than(2.34±0.26)L,(1.98±0.17)L,(40.29±3.58)%in the control group.The difference was significant(P<0.05).Before surgery,there were no significant differences in CD3^(+),CD4^(+),CD4^(+)/CD8^(+)and NK between the two groups(P>0.05).After the surgery,the observation group had CD3^(+)of(45.15±2.62)%,CD4^(+)of(34.66±2.22)%,CD4^(+)/CD8^(+)of(1.39±0.24)and NK of(19.58±1.52)%,which were better than(30.48±2.82)%,(28.23±2.14)%,(1.25±0.22)and(18.26±1.53)%in the control group,and the difference was significant(P<0.05).Conclusion Minimally invasive lobectomy and segmentectomy have good efficacy for nonsmall cell lung cancer,but minimally invasive segmentectomy treatment is more helpful to improve the immune function and lung function of patients,which is worth popularizing.