电视胸腔镜解剖性肺段切除术对早期非小细胞肺癌患者术后肺功能及炎症反应的影响

摘要/Abstract

摘要： 目的探讨电视胸腔镜解剖性肺段切除术治疗早期非小细胞肺癌（NSCLC）对患者术后肺功能及炎症反应的影响。方法选取2020年4月—2022年5月兰陵县人民医院收治的92例早期NSCLC患者为研究对象,按照手术方案不同分成对照组和观察组,各46例。对照组给予电视胸腔镜下肺叶切除术治疗,观察组给予电视胸腔镜下解剖性肺段切除术治疗。记录两组手术相关指标（手术时间、淋巴清扫数量、术中出血量、术后引流时间、术后引流量和术后住院时间）,对比手术前后两组肺功能[用力肺活量（FVC）、最大通气量（MVV）及第一秒用力呼气量（FEV₁）]及炎症反应指标[肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）及白细胞介素-6（IL-6）]的水平变化,术后随访6个月调查两组并发症发生率和复发率。结果与对照组相比,观察组患者的手术时间更长,但术中出血量、术后引流量更少,术后引流时间及住院时间更短,差异有统计学意义（P<0.05）;两组患者的淋巴清扫数量比较,差异无统计学意义（P>0.05）;术后30 d,两组FVC、MVV及FEV₁值较术前均下降,但观察组高于对照组,差异有统计学意义（P<0.05）;术后3 d,两组血清TNF-α、CRP及IL-6水平较术前均升高,但观察组低于对照组,差异有统计学意义（P<0.05）;术后,两组并发症总发生率、6个月内复发率比较,差异无统计学意义（P>0.05）。结论电视胸腔镜下解剖性肺段切除术治疗早期NSCLC具备显著的优势,能避免对患者的肺功能造成严重损害,改善炎症反应,使近期内疾病复发可能性降低,便于术后机体快速恢复,并且手术安全性高,可于临床应用。

关键词: 非小细胞肺癌, 肺功能, 电视胸腔镜解剖性肺段切除术

Abstract: Objective To investigate the effects of video-assisted thoracoscopic anatomic segmental resection on postoperative lung function and inflammatory response in patients with early non-small cell lung cancer (NSCLC). Methods A total of 92 patients with early stage NSCLC admitted to the Department of General Surgery of Lanling County People's Hospital from April 2020 to May 2022 were divided into two groups according to different surgical programs, with 46 patients in each group. The control group was treated with video-assisted thoracoscopic lobectomy, while the observation group was treated with video-assisted thoracoscopic anatomic segmental resection. Operation related indexes (operation time,number of lymph dissection, intraoperative blood loss, postoperative drainage time, postoperative drainage volume and postoperative hospital stay) were recorded in the two groups. The changes of lung function (forced vital capacity (FVC), maximum volume of air volume (MVV), forced expiratory volume in one second (FEV₁)) and inflammatory response indicators [tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and interleukin-6 (IL-6)] before and after operation were compared between the two groups. The complication rate and recurrence rate of the two groups were investigated after 6 months of follow-up. Results Compared with the control group, the operation time of the observation group was extended, but the intraoperative blood loss, postoperative drainage volume, postoperative drainage time and hospital stay were reduced, the difference was statistically significant (P<0.05). There was no significant difference in the number of lymph dissection between the two groups (P>0.05). 30 days after surgery, the values of FVC, MVV and FEV₁ in 2 groups were decreased compared with those before surgery, but the observation group was higher than the control group, the difference was statistically significant (P<0.05). At 3 days after operation, serum TNF-α, CRP and IL-6 in 2 groups were higher than those before operation, but the observation group was lower than the control group, the difference was statistically significant (P<0.05). After surgery, there was no significant difference in the total complication rate and recurrence rate within 6 months between the two groups (P>0.05). Conclusion Video-assisted thoracoscopic anatomic segmental resection in the treatment of early NSCLC has significant minimally invasive advantages, which can avoid serious damage to patients' lung function, improve inflammatory response, reduce the possibility of disease recurrence in the near term,facilitate rapid postoperative recovery of the body, and have high surgical safety, which can be applied in clinical application.

Key words: lung nodules, video thoracoscope, anatomical segmental pneumonectomy, lobectomy

中图分类号:

R734.2

刘响. 电视胸腔镜解剖性肺段切除术对早期非小细胞肺癌患者术后肺功能及炎症反应的影响[J]. 中华养生保健, 2023, 41(14): 20-24.

LIU Xiang. Effects of Video-assisted Thoracoscopic Anatomic Segmental Resection on Postoperative Lung Function and Inflammatory Response in Patients with Early Non-small Cell Lung Cancer[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(14): 20-24.

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