目的：观察胸腔镜肺叶切除术对非小细胞肺癌患者免疫功能的影响。方法依照不同术式将87例非小细胞肺癌患者分为两组，观察组（ n =44）采用胸腔镜手术（VATS），对照组（n =43）采用传统开胸术；比较两组患者的手术效果和 T 淋巴细胞亚群水平差异。结果观察组的手术时间、术中出血量、术中输血量以及住院时间均优于对照组（P <0.05）；两组患者术后3 d 时 CD +4、CD +8均较术前明显降低（P <0.05），术后15 d 时 CD +4水平逐渐恢复至术前，术后3d、15d 时 CD +4/ CD +8比值均较术前明显增高（P <0.05），同期组间比较，治疗15d 时观察组 CD +4、CD +4/ CD +8比值均较对照组明显增高（P <0.05）；术后3d、15d 时 NK 细胞水平均略低于术前水平，但差异无统计学意义（P >0.05）。结论胸腔镜肺叶切除术治疗非小细胞肺癌体现出微创手术优势，对患者免疫功能的抑制更轻，更利于患者的后期康复。%Objective To observe the influence of VATS lobectomy for patients with non-small cell lung cancer. Methods 87 patients with non-small cell lung cancer treated with different operation methods were selected and divided into two groups. The observation group(n = 44)was treated with VATS,and the control group(n = 43) was treated with traditional thoracotomy. The operation effect and T lymphocyte subgroup level difference of the two groups was compared. Results The operation time,bleeding amount in operation,blood infusion amount in opera-tion and duration of hospital stay of the observation group were better than those of the control group(P < 0. 05). The value of CD +4 and CD +8 were significantly lower 3d after surgery than preoperative in the two groups(P < 0. 05). The level of CD +4 was back to normal 15d after surgery,and the value of CD +4 / CD +8 was obviously higher 3d and 15d after surgery(P < 0. 05). The value of CD +4 and CD +4 / CD +8 was obviously higher in the observation group than in the con-trol group 15d after surgery(P < 0. 05),but the level of NK cells showed no significant difference between the two groups(P > 0. 05). Conclusion VATS lobectomy has the advantage of minimally invasive surgery in treatment of NSCLC patients. It not only can inhibit the immunologic function of the patients,but also is good for the late recovery of the patients.
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