【摘要】 目的 比较三孔和单孔胸腔镜手术对非小细胞肺癌患者围术期肾上腺素(E)、去甲肾上腺素(NE)、皮质醇(Cor)水平及并发症的影响。方法 选取2016年1月至2022年1月北京市大兴区人民医院非小细胞肺癌患者400例,根据手术治疗方式的不同分为单孔胸腔镜组(n=150)与三孔胸腔镜组(n=250)。比较两组患者围术期手术相关指标、应激指标、血清指标及术后疼痛程度、并发症发生情况。结果 单孔胸腔镜组手术时间明显长于三孔胸腔镜组,术中出血量、术后总引流量显著小于三孔胸腔镜组,引流管拔除时间以及住院天数显著少于三孔胸腔镜组,差异均有统计学意义(t=5.623、27.089、7.011、6.335、6.169,P<0.05);单孔胸腔镜组术后第1、3、5 d的视觉模拟评分法(VAS)评分显著低于三孔胸腔镜组,差异有统计学意义(t=17.902、14.460、14.122,P<0.05);术后单孔胸腔镜组应激指标E、NE以及Cor水平显著低于三孔胸腔镜组,差异有统计学意义(t=52.455、27.177、13.808,P<0.05)。术后两组转化生长因子-α(TGF-α)、癌抗原(CA)21-1、表皮生长因子受体(EGFR)水平比较,差异无统计学意义(t=0.919、1.668、0.847,P>0.05);单孔胸腔镜组并发症发生情况显著少于三孔胸腔镜组,差异有统计学意义(χ~2=4.263,P<0.05)。结论 与三孔胸腔镜相比,单孔胸腔镜治疗非小细胞肺癌,可减轻患者围术期应激反应,且能降低并发症发生率。更多还原

【Abstract】 Objective To compare the effects of three-port or single-port thoracoscopic surgery on levels of perioperative epinephrine（E）,norepinephrine（NE）and cortisol（Cor）and complications in patients with non-small cell lung cancer. Methods Totally 400 patients with non-small cell lung cancer in Beijing Daxing District People’ s Hospital from January 2016 to January 2022 were selected. According to the different surgical treatment methods,the patients were divided into the single-port thoracoscope group（n=150）and the three-port thoracoscope group（n=250）. The perioperative surgery-related indicators,stress indicators,serum indicators,postoperative pain degree and occurrence of complications were compared between the two groups of patients. Results The surgical time in single-port thoracoscope group was significantly longer than that in the three-port thoracoscope group,and the intraoperative blood loss and postoperative total drainage volume were significantly less than those in the three-port thoracoscope group,and the drainage tube removal time and hospital stay were significantly shorter compared to three-port thoracoscope group（t=5.623,27.089,7.011,6.335,6.169,P<0.05）. The Visual Analogue Scale（VAS）scores on the 1^st day,3^rd day and 5^th day after surgery were significantly lower in the single-port thoracoscope group than those in the three-port thoracoscope group（t=17.902,14.460,14.122,P<0.05）. After surgery,the levels of stress indicators such as E,NE and Cor in the single-port thoracoscope group were significantly lower than those in the three-port thoracoscope group（t=52.455,27.177,13.808,P<0.05）. There were no statistically significant differences in serum levels of transforming growth factor-α（TGF-α）,cancer antigen（CA） 21-1 and epidermal growth factor receptor（EGFR）between the two groups after surgery（t=0.919,1.668,0.847,P>0.05）. The occurrence of complications was significantly lower in the single-port thoracoscope group than that in the three-port thoracoscope group（χ²=4.263,P<0.05）. Conclusion Compared with the three-port thoracoscopic surgery,the single-port thoracoscopic surgery can better relieve the perioperative stress response and reduce the incidence rates of complications in the treatment of non-small cell lung cancer.更多还原