胸腔镜肺段切除术治疗老年早期非小细胞肺癌患者的效果

The Effect of Thoracoscopic Lung Segmentectomy in the Treatment of Elderly Patients with Early Non-small Cell Lung Cancer

目的:探讨胸腔镜肺段切除术治疗老年早期非小细胞肺癌(NSCLC)患者的效果。方法:选取2020年3月—2023年8月淄博市传染病医院收治的80例早期NSCLC患者,按随机数表法分为两组,每组各40例。对照组行胸腔镜肺叶切除术,观察组行胸腔镜肺段切除术。比较两组围手术期相关指标、肺功能指标、应激指标、免疫功能及并发症。结果:观察组手术用时较对照组长,术中出血量、术后引流量较对照组少,术后引流、住院时间较对照组短,差异有统计学意义(P<0.05);观察组术后用力肺活量(FVC)、第1 s用力呼气容积(FEV_(1))高于对照组,差异有统计学意义(P<0.05);观察组术后去甲肾上腺素(NE)、皮质醇(COR)、促肾上腺皮质激素(ACTH)水平低于对照组,差异有统计学意义(P<0.05);观察组术后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于对照组,CD8^(+)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:胸腔镜肺段切除术治疗老年早期NSCLC效果更佳,可减轻手术创伤,保护患者肺功能及免疫功能,安全可靠。

Objective:To explore the efficacy of thoracoscopic lung segmentectomy in the treatment of elderly patients with early Non-small Cell Lung Cancer(NSCLC).Method:80 early NSCLC patients admitted to Zibo Infectious Disease Hospital from March 2020 to August 2023 were selected and divided into two groups using a random number table method,with 40 cases in each group.The control group underwent thoracoscopic lobectomy,while the observation group underwent thoracoscopic segmental resection.The perioperative related indicators,lung function indicators,stress indicators,immune function and complications were compared between two groups.Result:The observation group had a longer surgical time,less intraoperative bleeding,less postoperative drainage volume,and shorter postoperative drainage and hospitalization time compared the control group,with statistical significance(P<0.05).The postoperative Forced Vital Capacity(FVC),first second Forced Expiratory Volume(FEV_(1))in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The postoperative levels of norepinephrine(NE),cortisol(COR)and Adrenocorticotropic Hormone(ACTH)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The postoperative CD3^(+),CD4^(+),CD4^(+)/CD8^(+)levels in the observation group were higher than those in the control group,while CD8 levels were lower than those in the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in comparison of complication rare between the two groups(P>0.05).Conclusion:Thoracoscopic segmental resection is more effective in the treatment of elderly patients with early NSCLC,which can reduce surgical trauma,protect lung function and immune function of patients,and it is safe and reliable.