摘要
【目的】探讨两孔式胸腔镜肺叶切除术联合系统性淋巴结清扫术治疗非小细胞肺癌（non-small cell lungcancer，NSCLC）的疗效。【方法】将2012年3月至2014年3月期间在本科诊断为肺癌并拟行肺叶切除加系统性淋巴结清扫的220例患者纳入研究。将患者按随机分为观察组和对照组，观察组患者接受两孔式胸腔镜肺叶切除术加系统性淋巴结清扫，对照组患者接受常规三孔式胸腔镜肺叶切除术加系统性淋巴结清扫。观察两组患者手术时间，清扫淋巴结数目及站数，术中中转（开胸／两孔转三孔）例数，下床活动时间，引流时间，并发症发生情况及术后住院时间；采用疼痛视觉模拟评分（visual analog scale，VAS）在术后d1、d3及d7评估患者疼痛情况，记录患者镇痛药物用量；对比局部复发情况及远处器官转移情况，分析评估3年总生存率及无进展生存率。【结果】两组患者在手术时间，清扫淋巴结数目及站数，术中中转开腹率及引流时间差异无统计学意义（P〉0．05）；观察组患者下床活动时间及术后住院时间较对照组缩短，差异具有统计学意义（P〈0．05）。观察组患者并发症发生率为26．21％，对照组为26．47％，两组差异无统计学意义（P〉0．05）。观察组患者术后Vas评分均低于对照组患者，但术后d，VAS评分两组之间差异无统计学意义（P〉0．05），术后d3及d7两组评分差异具有统计学意义（P〈0．05）。观察组患者镇痛药物用量少于对照组患者，差异具有统计学意义（P〈0．05）。两组患者局部复发率及远处器官转移率之间差异无统计学意义（P〉0．05），3年总生存率、无进展生存率及中位生存时间之间差异无统计学意义（P〉0．05）。【结论】与三孔式相比，两孔式胸腔镜肺叶切除术加系统性淋巴结清扫能够有效切除肺癌组织，获得满意疗效，并能有效�
[Objective]To study the therapeutic effect of two-port thoracoscopic lobectomy with systematic lymph node dissection on non-small cell tung eancer（NSCLC）.[Methods] A total of 220 patients with NSCLC who were diagnosed and prepared to undergo lobectomy with systematic lymph node dissection from March 2012 to March 2014 in our department were enrolled in this study. Patients were randomly divided into the observation group and the control group. Patients in the observation group underwent two-port thoracoscopic lobectomy with systematic lymph node dissection while patients in the control group underwent routine three-port thoracoscopie lo- bectomy with systematic lymph node dissection. The operation duration, numbers and stations of lymph nodes dis- sected, numbers experienced intraoperative transt （open thoracotomy / two to three-port thoracoscopic lobectomy switch）, ambulation time, chest tube duration, numbers of complications, hospital stay after surgery were ob- served in both groups. Visual analog scale（VAS）was used to evaluate the severity of postoperative pain of patients on the 1st, 3rd and 7th day after operation, and the analgesic dosages used after operation were also recorded. The follow-up information were collected, and the incidence rates of local recurrence and distant metastasis were com- pared. The 3-year overall survival rate and progress free survival rate were also analyzed. [Results]No significances were found between the two groups in operation duration, numbers and stations of lymph nodes dissected, incidence rates of intraoperative transit , and chest tube duration（ P 〈0.05）. The ambulation time and hospital stay after surgery of the observation group were significantly shorter than those of the control group（ P 〈0.05）. The complication rate of the observation group was 26.21%, which was lower than that of the control group（26.47 %）, but the difference had no statistical significance（ P〈0.05）. The VAS score of the observation group on the 1st day was lower
出处
《医学临床研究》
CAS
2017年第8期1548-1551,共4页
Journal of Clinical Research
