【摘要】 目的比较完全胸腔镜与传统开放手术治疗非小细胞肺癌(NSCLC)的感染率差异及相关因素。方法收集2010年6月-2011年6月胸外科手术治疗的NSCLC患者32例实施完全胸腔镜手术(试验组),同期33例NSCLC患者行传统开放手术作为对照组。结果对照组肺部感染1例,肺不张1例,心律不齐1例,切口感染1例,肩部活动障碍1例,术后并发症发生率为15.1%,其中术后感染的发生率为6.1%;试验组肩部活动障碍1例,术后并发症总体发生率为3.1%,其中感染发生率为0,两组术后感染发生率差异有统计学意义(P<0.01);治疗后30d与治疗前和术后5d比较,差异均有统计学意义(均P<0.05),试验组中VEGF减少更为显著(P<0.05);两组术后5dIL-6居于较高水平(P<0.05),术后30d降低显著,与对照组比,试验组降低幅度更大;试验组术中出血量比对照组少(P<0.05);试验组术后住院天数比对照组短(P<0.05);两组手术时间、术后引流天数、引流量差异均无统计学意义;两组VEGF术前和术后5d比较,差异均无统计学意义。结论术后免疫力差异导致两组感染发生率不同,完全胸腔镜较传统开放手术对患者手术创伤小、感染发生率低,可以改善患者的预后,是安全可靠的手术,值得临床推广。更多还原

【Abstract】 OBJECTIVE To compare the differences in infection rates between totally video-assisted thoracoscopic surgery and traditional open surgery during the treatment of non-small cell lung cancer(NSCLC) and investigate relevant factors.METHODS From Jun.2010 to Jun.2011 in our hospital,we compared the treatment of thoracic surgery for 32 patients with NSCLC underwent fully-assisted thoracic surgery and 33 NSCLC patients underwent traditional open surgery.RESULTS In the control group,there was 1 case of lung infection,1 case of atelectasis,1 case of arrhythmia,1 case of wound infection,and 1 case of shoulder movement disorder.The incidence of postoperative complications was 15.1% and the postoperative infection rate was 6.1%.In the test group,there was 1 case of shoulder movement disorder.The total incidence of postoperative complications was 3.1%.The incidence of infection was 0.The difference in the incidence of postoperative infections between the two groups was statistically significant(P<0.01).Thirty days after operation,VEGF in two groups significantly decreased compared with that before treatment and 5 days after operation(P<0.05) and decreased more significantly in totally video-assisted thoracoscopic surgery group(P<0.05).Five days after operation,IL-6 increased to a higher level(P<0.05) in both groups,and significantly decreased 30 days after operation.Compared with the control group,the level in the test group decreased more sharply(P<0.05).the blood loss in the test group was less than the control group(P<0.05);and hospitalization duration of the test group was shorter than the control group(P<0.05).Operative time,postoperative drainage days and drainage volume were not statistically different between the two groups;there was no significant difference in VEGF between the two groups before and 5 days after treatment.CONCLUSION The difference of immunity after surgery leads to different infection incidences inthe two groups.Compared with traditional open surgery,the totally video-assisted thoracoscopic surgery has less surgical trauma and lower infection rate and can improve the prognosis of patients.It is a safe and reliable operation and should be used widely.更多还原