【摘要】 目的探讨完全胸腔镜单向式肺叶切除+淋巴结清扫术在Ⅰ、Ⅱ期非小细胞肺癌切除中的优越性。方法选取2013年1月—2018年6月在成都市第六人民医院心胸外科诊治的Ⅰ、Ⅱ期非小细胞肺癌患者58例,均采用手术切除治疗。接受常规胸肺叶切除术+淋巴结清扫术治疗者设为对照组(n=29),接受完全胸腔镜单向式肺叶切除+淋巴结清扫术治疗者设为研究组(n=29),比较两组患者的手术指标、疼痛评分、炎症因子水平。结果研究组患者的切口长度、手术时间、术后住院时间均短于对照组(t=54.707,t=11.934,t=7.574,均P<0.001),术中出血量少于对照组(t=24.746,P<0.001);研究组患者的镇痛药物使用率低于对照组(6.9%vs 27.6%,χ~2=4.350,P=0.037),术后12、24、48 h的疼痛VAS评分也低于对照组(t=8.134,t=19.039,t=20.872;均P<0.001);研究组术后第1、3、7天的C反应蛋白水平均低于对照组(t=17.307,t=19.405,t=16.112,均P<0.001)。结论完全胸腔镜单向式肺叶切除联合淋巴结清扫术在Ⅰ、Ⅱ期非小细胞肺癌手术切除治疗中具有"微创"等优越性,可减轻患者术后疼痛感,并降低机体炎症水平,适宜推广。更多还原

【Abstract】 Objective To investigate the advantages of thoracoscopic unidirectional lobectomy plus lymphadenectomy in the resection of stageⅠ/Ⅱ non-small cell lung cancer. Methods Fifty-eight patients with stageⅠ/Ⅱ non-small cell lung cancer treated by thoracic surgery in Chengdu Sixth People’s Hospital from January 2013 to June 2018 were selected for this research. All patients underwent surgical resection: those who received conventional thoracotomy plus lymph node dissection were marked as in the control group(n=29), and those who received thoracoscopic unidirectional lobectomy plus lymph node dissection were marked as in the research group(n=29). The differences of operative index, pain and inflammatory factors between the two groups were statistically analyzed. Results The incision length, operation time and hospitalization time of the research group were shorter than those of the control group(t=54.707, t=11.934, t=7.574, all P<0.001), and intraoperative bleeding volume of the research group was less than that of the control group(t=24.746, P<0.001). The use rate of analgesics in the research group was 6.9% compared with 27.6% of the control group(χ~2=4.350, P=0.037), and the VAS scores of the researoh group at 12, 24 and 48 hours after operation were lower than those of the control group(t=8.134, t=19.039, t=20.872, all P<0.001); The level of C-reactive protein in research group was lower than that in control group(t=17.307, t=19.405, t=16.112, all P<0.001) on the 1 st, 3 rd and 7 th day after operation. Conclusions Complete thoracoscopic one-way lobectomy combined with lymph node dissection has the advantages of minimally invasive in the surgical treatment of stageⅠ/Ⅱ non-small cell lung cancer, which can reduce the pain after operation and reduce the level of inflammation, and is suitable for promotion.更多还原