全胸腔镜肺叶切除术与开放肺叶切除术治疗早期肺癌的对比研究

摘要

目的 探讨全胸腔镜肺叶切除术在早期肺癌治疗中的临床应用价值.方法 选取本院行肺叶切除术治疗的早期非小细胞肺癌(NSCLC)患者64例,按其手术方式分为电视胸腔镜手术(VATS)组(n=32,行全胸腔镜肺叶切除术)及OT组(n=32,行传统开胸肺叶切除术).比较两组患者淋巴结清扫组数、手术持续时间、术中出血量、术后置管引流时间、术后住院时间、术后并发症发生率、术后疼痛评分及血清C反应蛋白(CRP)的差异.结果 两组患者的淋巴结清扫组数、手术持续时间、术中出血量、术后住院时间及术后并发症发生率比较,差异均无统计学意义(P＞0.05).VATS组术后置管引流时间明显少于OT组(P＜0.05).术后第1、3天OT组疼痛评分明显高于VATS组(P＜0.05).两组患者术后第1、5天血清CRP均较术前明显升高(P＜0.05),VATS组于术后第1、5天时间点的血清CRP水平均明显低于同时间点OT组(P＜0.05).结论 全胸腔镜肺叶切除术安全、可靠,具有术后恢复快的优点,可作为早期肺癌患者的推荐治疗方法.%Objective To explore the clinical application value of complete video assisted thoracoscopic pneumonectomy in treatment of lung cancer at early stage. Methods 64 patients with early stage non-small cell lung cancer(NSCLC) accepted pneumonectomy were collected. According to surgical approach, they were divided into VAST group(n-32, undergone complete video-assisted thoracoscopic pneumonectomy) and OT group(n=32, undergone traditional open pneumonectomy). Differences of numbers of lymph nodes removal,operation duration,volumes of intraoperative bleeding, duration of postoperative catheter drainage, length of postoperative hospital stay,incidence rates of postoperative complication, postoperative pain scores and levels of serum C-reaction protein(CRP) of patients in the two groups were compared. Results There were no significant differences in numbers of lymphnodes removal, operation duration, volumes of intraoperative bleeding, length of postoperative hospital stay, incidence rates of post operative complication between the two groups (P＞ 0. 05). However, duration of postoperative catheter drainage of patients in VATS group were less than those in OT group(P＜0.05). Pain scores of patients in OT group on the first and third day after operation were higher than those in VATS group(P＜0.05). Levels of postoperative serum CRP of patients in the two groups were both higher than those before operation(P＜0.05) ,and levels of serum CRP of patients in VATS group on the first and fifth day after operation were markedly lower than those at the same time point in OT group(P＜0.05). Conclusion Complete video-assisted thoracoscopic pneumonectomy is safe and reliable,and can be recommended as an early treatment of lung cancer with advantage of rapid recovery.