单孔胸腔镜下肺亚段/肺段切除术在肺结节<2cm的老年患者中的临床应用

Clinical Application of Single-port Thoracoscopic Pulmonary Subsegmental/Segmentectomy in Elderly Patients with Pulmonary Nodules<2 cm

目的:探究单孔胸腔镜下肺亚段/肺段切除术在肺结节<2 cm的老年患者中的临床应用。方法:选取无锡市惠山区人民医院胸外科在2021年6月—2023年6月收治的100例肺结节<2 cm的老年患者作为研究对象,按随机数字表法分为观察组与对照组,每组50例。对照组行单孔胸腔镜下肺段切除术,观察组行单孔胸腔镜下肺亚段切除术。观察两组手术相关指标、术后疼痛程度[视觉模拟评分法(VAS)]及并发症发生情况。结果:观察组手术时间、住院时间均短于对照组,术中出血量与术后引流量均少于对照组,差异均有统计学意义(P<0.05)。两组术后5 d的VSA评分均低于术后1、3 d,术后3 d的VAS评分均低于术后1 d,差异均有统计学意义(P<0.05);观察组术后1、3、5 d的VAS评分均低于对照组,差异均有统计学意义(P<0.05)。观察组并发症发生率为6.00%,对照组为12.00%,差异无统计学意义(P>0.05)。结论:与单孔胸腔镜下肺段切除术相比,单孔胸腔镜下肺亚段切除术对肺结节<2cm的老年患者的创伤更小,更加有效地改善手术相关指标,减少术后疼痛。

Objective:To investigate the clinical application of single-port thoracoscopic pulmonary subsegmental/segmental resection in elderly patients with pulmonary nodules<2 cm.Method:A total of 100 elderly patients with pulmonary nodules<2 cm who were admitted to the Department of Thoracic Surgery of Wuxi Huishan District People's Hospital from June 2021 to June 2023 were selected as the study subjects,and were divided into observation group and control group according to the random number table method,with 50 cases in each group.The control group underwent single-port thoracoscopic segmental resection,while the observation group underwent single-port thoracoscopic subsegmental resection.The operation-related indexes,postoperative pain degree[visual analogue scale(VAS)]and incidence of complications in the two groups were observed.Result:The operation time and hospital stay in the observation group were shorter than those in the control group,and the intraoperative blood loss and postoperative drainage volume were lower than those in the control group,the differences were statistically significant(P<0.05).The VSA scores of both groups at 5 days postoperatively were lower than those at 1 and 3 days postoperatively,and the VAS scores at 3 days postoperatively were lower than those at 1 day postoperatively,the differences were statistically significant(P<0.05);the VAS scores of the observation group at 1,3 and 5 d after operation were lower than those of the control group,the differences were statistically significant(P<0.05).The incidence of complications in the observation group was 6.00%,while it in the control group was 12.00%,the difference was not statistically significant(P>0.05).Conclusion:Compared with single-port thoracoscopic segmentectomy,single-port thoracoscopic subsegmentectomy is less invasive for elderly patients with pulmonary nodules<2 cm,which is more effective in improving surgery-related indicators,reducing postoperative pain.