胸腔镜肺癌根治术和开胸肺癌根治术的临床疗效比较

Comparison of efficacy between lung resection by thoracoscopic surgery and thoracotomy with lung resection

目的探讨胸腔镜肺癌根治术对肺癌患者的临床疗效、代谢反应及疼痛度的影响。方法选取2013年8月至2018年1月间宝鸡市人民医院收治的行手术治疗的108例肺癌患者,采用随机数表法分为观察组和对照组,每组54例。观察组患者行胸腔镜肺癌根治术,对照组患者行开胸肺癌根治术,比较两组患者手术情况、代谢反应及疼痛度。结果两组患者淋巴结清扫数量比较,差异无统计学意义(P> 0. 05);观察组患者手术时间、出血量、切口长度、引流时间和住院时间均优于对照组,差异均有统计学意义(均P <0. 01)。与术前比较,两组患者术后前清蛋白(PA)、转铁蛋白(TRF)和视黄醇结合蛋白(RBP)水平均下降,胰高血糖素(GN)、血清胰岛素(INS)和血糖(Glu)水平均上升,差异均有统计学意义(均P <0. 01)。且观察组术后PA、TRF和RBP水平较对照组高,GN、INS和Glu水平较对照组低,差异均有统计学意义(均P <0. 01)。术后,两组患者前列腺素、P物质和缓激肽水平均较术前提高,且观察组各指标含量均较对照组低,差异均有统计学意义(均P <0. 01)。结论微创肺癌根治术具有术时短、出少血量和恢复快等优势,对患者术后代谢反应影响小,可减轻术后疼痛应激性,安全有效。

Objective To analyze the effects of lung resection by thoracoscopic surgery on the clinical efficacy,metabolic reaction and pain.Methods A total of 108 patients with lung cancer who underwent surgical treatment at Baoji People’s Hospital between August 2013 and January 2018 were selected.According to the different surgical methods,these patients were divided into an observation group and a control group,with 54 cases in each group.The observation group received lung resection by thoracoscopic surgery and the control group underwent thoracotomy with lung resection.The surgery results,metabolic reaction and pains were compared between the two groups.Results There was no significant difference in number of lymph nodes removed between the two groups(P>0.05).The operation duration,intraoperative blood loss,incision length,duration of drainage,and length of hospital stay were better in the observation group than in the control group(all P<0.05).Postoperative prealbumin(PA),transferrin(TRF),and retinol-binding protein(RBP)decreased in both groups with the above levels higher in the observation group than in the control group(all P<0.05).The levels of glucagon(GN),serum insulin(INS)and glucagon(Glu)increased in both groups with the above levels lower in the observation group than in the control group(all P<0.05).Conclusion Minimally invasive lung resection for lung cancer is safe and effective,which boasts the advantages of short operation duration,little blood loss and fast recovery,producing little impact on postoperative metabolic reactions and relieves postoperative pain stress.