【摘要】 目的：研究CT引导硬化剂与体表定位联合单孔胸腔镜下解剖性肺部分切除术治疗非小细胞肺癌（NSCLC）患者的临床效果。方法：选取2019年3月—2021年12月在我院治疗的NSCLC患者202例，根据患者住院病历号末尾奇偶数分为观察组（n=110）和对照组（n=92）。两组患者均给予单孔胸腔镜下解剖性楔形切除术，其中观察组应用CT引导硬化剂与体表定位。观察两组手术时间、术中出血量等指标，以及手术前后肺功能、肿瘤标志物及预后情况。结果：观察组手术时间、术中出血量、术后引流量分别为（154.31±34.45）min、（270.50±40.06）mL和（410.50±91.14）mL，明显少于对照组（P <0.05），胸腔置管引流时间为（5.60±1.09）d，明显短于对照组（P <0.05）。观察组一次性定位成功率为98.18%，明显高于对照组的88.04%(P <0.05)。观察组术后1个月最大通气量（MVV）、峰值呼气流速（PEF）、第一秒用力呼气容积（FEV1）和用力肺活量（FVC）分别为（77.79±8.16）L、（58.87±6.03）L/min、（1.81±0.44）L和（2.60±0.81）L，明显高于对照组（P <0.05）。观察组和对照组术后1个月细胞角蛋白19的可溶性片段（CYFRA21-1）、癌胚抗原（CEA）、糖类抗原199(CA199)和鳞状细胞癌抗原（SCC）比较，差异无统计学意义（P <0.05）。观察组和对照组术后1个月QLQ-C43量表各项目评分比较，差异无统计学意义（P>0.05）。观察组和对照组中位无病生存期、总生存期差异比较，差异无统计学意义（P>0.05）。结论：CT引导硬化剂与体表定位联合单孔胸腔镜下解剖性肺部分切除术对NSCLC患者肺功能损伤轻，对患者预后无明显影响。更多还原

【Abstract】 Objective To investigate the effect of CT guided sclerosing agent and body surface localization combined with single hole thoracoscopic anatomical partial resection on patients with non-small cell lung cancer(NSCLC). Methods 202 patients with NSCLC treated in our hospital from March 2019 to December 2021 were divided into observation group(n = 110) and control group(n = 92) according to the odd and even number at the end of the inpatient medical record number. The patients in both groups were treated with anatomical cuneiform resection under single hole thoracoscope. The observation group was treated with CT guided sclerosing agent and body surface positioning. The control group was treated with body surface positioning. The operation time,intraoperative bleeding, lung function, tumor markers, prognosis before and after operation and other indexes of two groups were observed. Results The operation time, amount of intraoperative bleeding and postoperative drainage volume in the observation group were(154.31±34.45) min,(270.50±40.06) m L,(410.50±91.14) m L respectively, which were significantly less than those in the control group(P < 0.05). The drainage time of thoracic catheterization was(5.60±1.09) d, which was significantly shorter than that in the control group(P <0.05). The success rate of one-time localization in the observation group was 98.18%, which was significantly higher than that in the control group 88.04%(P <0.05). One month after operation, maximum ventilation volume (MVV), peak expiratory flow rate(PEF), forced expiratory volume in the first second(FEV1) and forced vital capacity(FVC) in the observation group were(77.79±8.16)L,(58.87±6.03) L/min,(1.81±0.44)L and(2.60 ±0.81)L respectively, which were significantly higher than those in the control group(P < 0.05). There were no significant differences in soluble fragment of cytokeratin 19(CYFRA21-1), carcinoembryonic antigen(CEA), carbohydrate antigen 199(CA199)and squamous cell carcinoma antigen(SCC) at one month after operation between the observation group and the control group(P < 0.05). The QlQ-C43 scale scores of the observation group and the control group were significantly different at one month after surgery(P > 0.05). There were no significant differences in median disease-free survival and overall survival between the observation group and the control group(P > 0.05).Conclusion CT guided sclerosing agent and body surface localization combined with single hole thoracoscopic anatomical partial pneumonectomy has less lung function injury in patients with NSCLC, but it has no significant effect on the prognosis of patients.更多还原