目的 分析电视辅助胸腔镜手术(VATS)和后外侧开胸手术(PLT)治疗早期非小细胞肺癌患者对术后免疫功能的影响.方法 80例早期非小细胞肺癌患者被随机分成实验组(胸腔镜组,n=40)和对照组(后外侧开胸组,n=40),对两组患者术后的创伤情况、免疫功能状态进行比较分析.结果 实验组的创伤指标(手术时间、住院时间、术中出血量和术中输血量)显著低于对照组,差异具有明显的统计学意义(P<0.05);实验组和对照组术后3天外周血炎症因子(C反应蛋白、血清淀粉样蛋白、白介素-6和白介素-2受体)均有所升高,但实验组升高幅度低,差异具有统计学意义(P<0.05);实验组和对照组术后3 d、7 d检测到的CD4+、CD8+、CD4+/CD8+比例和NK细胞、L细胞数量均有不同程度的降低,但实验组下降程度明显低于对照组,差异具有统计学意义(P<0.05).结论 胸腔镜手术较后外侧开胸术治疗早期非小细胞肺癌,对患者的创伤程度低,有助于术后免疫功能的保护,患者的生存状态良好.%Objective To evaluate the effect of video-assisted thoracoscopic surgery ( VATS) and posterolat-eral thoracotomy ( PLT ) on postoperative immune function in patients with early non-small cell lung cancer ( NSCLC) . Methods 80 patients with early non-small cell lung cancer were randomly divided into the experimental group (n=40) and the control group (posterolateral thoracotomy, n=40). Their trauma and immunological function state were comparatively analyzed. Results The trauma indexes( operation time, hospital stay, intraoperative blood loss and intraoperative blood transfusion) in the experimental group were significantly lower than those in the control group(P<0. 05). 3 days after operation, the peripheral blood inflammatory factors (C-reactive protein, serum amy-loid, interleukin-6 and interleukin-2 receptors) increased in the two groups, but they were more pronounced in the control group than in the experiment group (P<0. 05). The percentage of CD4+,CD8+,CD4+ /CD8+ and the number of NK cells and L cells were significantly lower in the experiment group than in the control group 3 and 7 days after oper-ation(P<0. 05). Conclusion Thoracoscopic surgery is more effective in the treatment of early non-small cell lung cancer, which is beneficial to the protection of postoperative immune function and the survival of patients.
展开▼
