摘要
目的探讨早期肺癌患者采用胸腔镜肺叶切除术与胸腔镜肺段切除术治疗的疗效比较。方法选取2018年4月至2020年5月间陕西省肿瘤医院收治的180例早期肺癌患者为研究对象,采用随机抽签的方式分为观察组和对照组,每组90例。对照组患者采用胸腔镜肺叶切除术治疗,观察组患者采用胸腔镜肺段切除术治疗,对比两组患者围术期指标、肺功能指标及5年生存率。结果观察组患者手术用时长于对照组,差异有统计学意义(P<0.05)。观察组患者住院天数短于对照组,差异有统计学意义(P<0.05)。两组患者术中出血量比较,差异无统计学意义(P>0.05)。两组患者术前用力肺活量占预计值的百分比(FVC%)及第1秒用力呼气容积占预计值的百分比(FEV1%)比较,差异无统计学意义(P>0.05)。术后6个月,观察组患者FVC%及FEV1%指标均优于对照组,差异均有统计学意义(均P<0.05)。观察组患者5年生存率为58.9%,低于对照组的77.8%,差异有统计学意义(P<0.05)。结论早期肺癌患者可选取胸腔镜肺叶切除术与胸腔镜肺段切除术两种手术方式,前者手术用时更短,但患者住院时间更长,后者对患者肺功能的保护更有利,但患者5年生存率低,临床可根据患者实际情况选择适宜的手术方式。
Objective To investigate the efficacy of thoracoscopic lobectomy versus thoracoscopic segmental resection for early lung cancer.Methods A total of 180 patients with early lung cancer admitted to the Shaanxi Cancer Hospital were selected from April 2018 to May 2020.They were randomly assigned to an observation groups and a control group using random table method with 90 patients in each group.The observation group underwent thoracoscopic segmental resection and the control group underwent thoracoscop-ic lobectomy.The perioperative indexes,changes in lung function and 5-year survival rate were compared between the two groups.Results The operation duration was longer in the observation group than in the control group(P<0.05).The length of hospital stay was shorter in the observation group than in the con-trol group(P<0.05).There was no statistically significant difference in intraoperative blood loss between the two groups(P>0.05).The differences in preoperative forced vital capacity(FVC)and forced expira-tory volume in one second(FEV1)were not statistically significant between the two groups(P>0.05).At 6 months after the operation,FVC and FEV1 levels were significantly better in the observation group than in the control group(all P<0.05).The 5-year survival rate was 58.9%in the observation group,which was significantly lower than 77.8%of the control group(P<0.05).Conclusions Patients with early lung cancer can choose either of the two surgical methods:thoracoscopic lobectomy and thoracoscopic segmentec-tomy.The former takes short operation time,but length of hospital stay is long,and the latter is beneficial to the protection of lung function,but the 5-year survival rate is low.Thus,an appropriate surgical method should be selected according to the actual situation of a patient.
作者
张新伟
王瑞洁
雷光焰
宋养荣
王成
吕卫东
张曦
ZHANG Xin-wei;WANG Rui-jie;LEI Guang-yan;SONG Yang-rong;WANG Cheng;LYU Wei-dong;ZHANG Xi(Department of Thoracic Surgery,Shaanxi Cancer Hospital,Xi'an 710061,China;Department of In-ternal Medicine,Xi'an Dongfang Hospital,Xi'an 710043,China)
出处
《中国肿瘤临床与康复》
2021年第10期1212-1215,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
