【摘要】 目的探讨全胸腔镜与常规开胸肺叶切除术治疗肺癌患者的效果。方法接受手术治疗的58例肺癌患者,通过随机数字表法分为对照组(常规开胸肺叶切除术)及研究组(全胸腔镜下肺叶切除术)。术后统计对比两组不同时间段[术前(T1)、单肺通气即刻(T2)、单肺通气后0.5 h(T3)及手术结束时(T4)]血流动力学指标[心率(HR)、平均动脉压(MAP)]及免疫细胞因子(CD4+、CD8+、CD4+/CD8+)水平变化情况。结果 T1时期两组HR、MAP水平比较,差异无统计学意义(P>0.05),T2、T3、T4时期两组HR、MAP水平较T1时期有所变化(P<0.05),且对照组变化更加明显,与研究组对比,差异有统计学意义(P<0.05)。术前两组CD4+、CD8+、CD4+/CD8+水平比较,差异无统计学意义(P>0.05),术后两组CD4+、CD8+、CD4+/CD8+水平较术前降低(P<0.05),且对照组变化更加明显,与研究组对比,差异有统计学意义(P<0.05)。结论全胸腔镜下肺叶切除术治疗肺癌效果优于常规开胸肺叶切除术,术中血流动力学较稳定,对免疫功能影响小,值得推广。更多还原

【Abstract】 Objective To investigate the effect of total thoracoscopiy and conventional thoracotomy on lung cancer. Methods 58 patients with lung cancer underwent surgical treatment were randomly divided into control group(conventional lobectomy)and study group(thoracoscopic lobectomy). Different time periods [preoperative(T1),single lung ventilation instantly(T2),0.5 h after single lung ventilation(T3)and at the end of surgery(T4)] hemodynamics [heart rate(HR),mean arterial pressure(MAP)and immune cytokines(CD4+, CD8+, CD4+/CD8+)levels were statistically compared between two groups. Results There were no significant differences in HR and MAP levels of T1 between the two groups(P> 0.05). The levels of HR and MAP in T2,T3 and T4 were significantly higher than those in T1(P<0.05),and the change in the control group was more obvious than that in the study group(P<0.05).There was no significant difference in CD4+,CD8+,CD4+/CD8+levels before treatment between the two groups(P>0.05). The levels of CD4+,CD8+and CD4+/CD8+after treatment were significantly lower than those in before treatment between the two groups(P<0.05),and the change in the control group was more obvious than that in the study group(P<0.05). Conclusion Total thoracoscopic lobectomy treatment of lung cancer is superior to conventional lobectomy,the hemodynamics is stable and the effect of immune function is small.So it is worthy of promotion.更多还原