3D-CTBA技术辅助早期肺癌胸腔镜肺段切除术的效果

Effect of 3D-CTBA Technology Assisted Thoracoscopic Segmentectomy for Early Lung Cancer

目的探讨三维肺支气管血管重建(3D-CTBA)技术在早期肺癌胸腔镜肺段切除手术中的应用价值。方法选取2020年1月至2022年10月河南科技大学附属许昌市中心医院收治的早期肺癌患者60例,按照随机数字表法分为对照组和3D组,各30例。对照组接受CT下胸腔镜肺段切除术,3D组接受3D-CTBA技术下胸腔镜肺段切除术。比较两组临床疗效、手术相关指标、手术前后机体创伤指标[C反应蛋白(CRP)、肾上腺素(E)、皮质醇(Cor)、血管紧张素Ⅰ(AngⅠ)]、肺功能指标[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)和最大通气量(MVV)]、肿瘤标志物[糖类抗原125(CA125)、癌胚抗原(CEA)、细胞角质蛋白19片段(CYFRA21-1)]及并发症发生率。结果3D组患者总有效率高于对照组(P<0.05),术中出血量、术后胸腔总引流量低于对照组(P<0.05),手术时间、胸引管留置时间、住院时间短于对照组(P<0.05),CRP、E、Cor、AngⅠ均低于对照组(P<0.05),FEV_(1)、FVC、MVV高于对照组(P<0.05),并发症总发生率与对照组差异无统计学意义(P>0.05)。结论3D-CTBA技术辅助胸腔镜肺段切除术是早期肺癌安全可靠的治疗方案,能减轻机体创伤,促进术后早期病情恢复,改善患者肺功能,能确保治疗安全性。

Objective To investigate the value of three dimensional pulmonary bronchial revascularization(3D-CTBA)technique in thoracoscopic segmental lung resection for early lung cancer.Methods Sixty early lung cancer patients admitted to Xuchang Central Hospital Affiliated to Henan University of Science and Technology from January 2020 to October 2022 were randomly divided into a control group and a 3D group,with 30 patients in each group,using a random number table method.The control group underwent CT assisted thoracoscopic segmentectomy,while the 3D group underwent 3D-CTBA assisted thoracoscopic segmentectomy.The clinical efficacy and surgery-related indexes of the two groups were compared,as well as the body trauma indexes[C-reactive protein(CRP),epinephrine(E),cortisol(Cor),angiotensin I(Ang I)],lung function indexes[force expiratory volume in one second(FEV_(1)),forced vital capacity(FVC)and maximal ventilatory volume(MVV)]before and after the surgery,and the complication rates were compared between the two groups.Results The total effective rate of patients in the 3D group was higher than that in the control group(P<0.05),and the intraoperative blood loss and postoperative total chest drainage volume were lower than those in the control group(P<0.05),the operation time,chest drainage tube retention time,and hospitalization time were shorter than those in the control group(P<0.05),CRP,E,Cor,and Ang I were all lower than those in the control group(P<0.05),while FEV_(1),FVC,and MVV were higher than those in the control group(P<0.05).There was no statistically difference in the total incidence of complications between the 3D group and the control group(P>0.05).Conclusion 3D-CTBA assisted thoracoscopic segmental resection is a safe and reliable treatment for early lung cancer,which can reduce body trauma,promote early postoperative recovery,improve lung function and ensure the safety of treatment.