摘要
目的单孔和三孔胸腔镜下肺癌根治术的治疗效果及对疼痛反应、免疫功能、炎性反应、肺功能的对比分析。方法随机选取2019年6月—2021年6月徐州医科大学附属徐州市立医院(徐州市第一人民医院)收治的肺癌患者110例,根据手术方式不同将患者分为两组,采用三孔胸腔镜肺癌根治术的55例患者纳入三孔组,采用单孔胸腔镜肺癌根治术的55例患者纳入单孔组,对比分析两种手术方式的治疗效果及疼痛反应、免疫功能、炎性反应、肺功能的情况。结果单孔组术中出血量(118.36±11.37)mL、拔管时间(4.18±0.42)d、住院时间(11.06±1.23)d,均低于三孔组,差异有统计学意义(t=2.807、7.712、3.026,P<0.05)。术后,单孔组并发症发生率为3.64%,低于三孔组的16.36%,差异有统计学意义(χ^(2)=4.949,P<0.05);单孔组12、24、72 h的VAS评分为(6.23±0.42)分、(4.76±0.35)分、(1.78±0.25)分,均低于三孔组,差异有统计学意义(P<0.05);单孔组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均高于三孔组,差异有统计学意义(P<0.05),单孔组CD8^(+)水平与三孔组相近,差异无统计学意义(P>0.05);单孔组CRP、PCT指标均低于三孔组,差异有统计学意义(P<0.05);单孔组FEV_(1)、FVC、FEV_(1)/FVC均高于三孔组,差异有统计学意义(P<0.05)。结论单孔相较于三孔胸腔镜下肺癌根治术,可有效降低术后应激反应及并发症,降低机体免疫功能损伤,更好保护患者肺功能,因此临床治疗肺癌患者更具优势,值得推广。
Objective The treatment effect of single and triple thoracoscopic radical lung cancer and the comparative analysis of pain response,immune function,inflammatory response and lung function.Methods From June 2019 to June 2021,110 lung cancer patients admitted to Xuzhou Municipal Hospital of Xuzhou Medical University(Xuzhou First People's Hospital)were randomly selected,and the patients were divided into two groups according to different surgical methods,55 patients who underwent three-hole thoracoscopic radical resection of lung cancer were included in the three-port group,and 55 patients who underwent single-hole thoracoscopic radical resection of lung cancer were included in the single-port group,comparative analysis of the therapeutic effects of the two surgical methods,pain response,immune function,inflammatory response,and lung function.Results The intraoperative blood loss(118.36±11.37)mL,extubation time(4.18±0.42)d and length of hospital stay(11.06±1.23)d in the single-hole group were significantly lower than those in the three-well group,the difference were statistically significant(t=2.807,7.712,3.026,P<0.05).Postoperative complication rate of single-hole group were 3.64%,which was significantly lower than that of three-well group 16.36%,the difference was statistically significant(χ^(2)=4.949,P<0.05).VAS scores of single-hole group at 12 h,24 h and 72 h were(6.23±0.42)points,(4.76±0.35)points,(1.78±0.25)points,which were lower than those of three-hole group,the difference was statistically significant(P<0.05).The levels of CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) in single-hole group were higher than those in three-hole group,the difference was statistically significant(P<0.05),and CD8^(+) in single-hole group was similar to that in three-hole group,the difference was not statistically significant(P>0.05).CRP and PCT indexes in single-hole group were lower than those in three-hole group,the difference was statistically significant(P<0.05).FEV_(1),FVC and FEV_(1)/FVC in single-hole group were higher than those in three-hole group,the difference was statistically significant(P<0.05).Conclusion Compared with the three-hole thoracoscopic radical lung cancer,the single hole effectively reduces the postoperative stress response and complications,reduces the body's immune function injury,and better protects the lung function of patients.Therefore,the clinical treatment of lung cancer patients has more advantages and is worth promoting.
作者
王峦
陈新于
朱守营
潘家俊
韩冬
WANG Luan;CHEN Xinyu;ZHU Shouying;PAN Jiajun;HAN Dong(Department of Thoracic and Cardiovascular Surgery,Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University(Xuzhou First People's Hospital),Xuzhou,Jiangsu Province,221000 China)
出处
《中外医疗》
2021年第26期65-68,共4页
China & Foreign Medical Treatment
关键词
单孔
三孔
胸腔镜肺癌根治术
免疫功能
肺功能
Single pore
Three holes
Thoracoscopic radical resection of lung cancer
Immunity
Pulmonary function
