摘要
目的探讨非小细胞肺癌微创及开胸根治术后炎症指标及生活质量评分变化的情况。方法选取Ⅰ~Ⅱ期非小细胞肺癌患者共62例,按照不同术式分为胸腔镜组(26例)和开胸组(36例),比较2组患者围术期临床指标、手术前后C-反应蛋白、术后VAS评分及术后并发症发生率等差异。结果胸腔镜组患者住院时间、术中出血量、引流管引流时间及术后活动时间均显著优于开胸组(P<0.05);而2组患者手术时间及术中淋巴结清扫组数比较,无统计学差异(P>0.05)。2组患者术前C-反应蛋白差异无统计学意义(P>0.05);而术后第1、4、7天对比2组患者C-反应蛋白变化情况,胸腔镜组均低于开胸组(P<0.05)。胸腔镜组患者术后并发症发生率(11.54%)显著低于开胸组(27.78%)。胸腔镜组患者术后第1、3、10天VAS评分均显著低于开胸组(P<0.05);2组在一般健康情况、躯体疼痛及精力3个方面的得分有统计学差异(P<0.05),而余项未见明显差异(P>0.05)。结论与传统开胸手术相比,胸腔镜手术创伤小、出血少、恢复快、术后疼痛轻,能有效降低术后炎症反应,提高患者生存质量,值得临床上大力推广。
Objective To observe and compare the effects of two kinds of pulmonary lobectomy onperioperative clinical indexes ,inflammatory reaction and quality of life scores of patients with non-small cell lung cancer. Methods 62 patients with NSCLC in stage I -II were randomly divided into the 2 groups ： VATS group （ n = 26） and thoracotomy group （ n = 36）, the perioperative clinical indexes,inflammatory reaction and quality of life scores were observed and compared between the 2 groups. Results The intraoperative hemorrhage volume, chest grainage time, out-of-bed activity time and length of hospital stay in VATS group were superior to those in thoracotomy group（P 〈 0.05 ）. However there were no significant differences in number of lymph node dissection and operation time between the 2 groups （ P 〉 0.05 ） ; The levels of CRP on 1 d,4 d,7 d after operation in VATS group were significantly lower than those in thoracotomy group （P 〈 0.05 ） ;The incidence of postoperative complications in VATS group （ 11.54 % ） was significantly lower than that in thoracotomy group （ 27.78 % ） （ P 〈 0.05 ） ; The VAS scores on 1 d, 3 d, 10 d after operation in VATS group were significantly lower than those in thoracotomy group（P 〈 0.05 ） ;There were significant differ- ences in general health, body pain and vigor between the 2 groups （P 〈 0.05）. Conclusion Compared with traditional thoracoto- my, the VATS pulmonary lobectomy can be used as a non-small cell lung cancer with the advantages of mix trauma, less bleeding and pain, less postoperative inflammatory reaction and can improve quality of life scores of patients, thus it is worthy of promoting.
作者
汪涛
朱金美
胡俊
WANG Tao ,ZHU Jinmei,HU Jun.(Huangshan Shoukang Hospital of Anhui,Huangshan,24500)
出处
《实用癌症杂志》
2018年第4期584-587,共4页
The Practical Journal of Cancer
关键词
胸腔镜
传统开胸手术
非小细胞肺癌
炎症反应
生存质量
VATS
Traditional thoracotomy
Non-small cell lung cancer
Inflammatory reaction
Quality of life
