摘要
目的 探讨早期非细胞肺癌患者电视辅助胸腔镜手术的临床效果.方法 选择130例早期非小细胞肺癌患者,采用随机数字表法分为观察组和对照组,每组65例.观察组采用电视辅助胸腔手术,对照组采用传统开胸手术.比较两组围术期情况;于手术前24 h、手术后24 h采集患者空腹静脉血,测定T细胞亚群（CD3＋、CD4＋、CD4＋/CD8＋）的变化;记录术后并发症;并随访1年,记录病死率及复发率.结果 两组淋巴结清扫个数差异无统计学意义（t=1.023,P〉0.05）;观察组手术时间明显长于对照组（t=6.479,P〈0.05）,观察组术中出血量明显少于对照组,术后引流时间、下床活动时间明显短于对照组,疼痛评分明显低于对照组,差异均有统计学意义（t=17.081、16.040、39.443、21.237,均P〈0.05）;手术后,两组CD3＋、CD4＋、CD4＋/CD8＋较手术前均显著降低（观察组：t=5.591、5.300、4.300,对照组：t=10.450、10.735、4.883,均P〈0.05）,观察组CD3＋、CD4＋、CD4＋/CD8＋明显高于对照组[（58.95±7.58）％比（52.42±7.52）％,（34.83±3.75）％比（30.07±3.12）％,（1.21±0.17）比（1.15±0.13）,t=4.931、7.867、2.260,均P〈0.05];观察组并发症发生率明显低于对照组[6.15％（4/65）比18.46％（12/65）,χ2=4.561,P〈0.05];随访1年,两组生存率、复发率差异均无统计学意义（χ2=0.367、0.208,均P〉0.05）.结论 在早期非小细胞肺癌患者中应用电视辅助胸腔镜手术效果显著,对患者创伤小,恢复快,且有助于保护机体免疫功能.
Objective To study the clinical effect of video - assisted thoracoscopic surgery in the treatment of early non - small cell lung cancer （NSCLC）. Methods 130 cases with early NSCLC were selected. According to random number table, the patients were divided into the observation group and the control group, 65 cases in each group. The observation group was treated with video - assisted thoracoscopic surgery, while the control group was treated with thoracotomy. The perioperative period of the two groups was compared,24h before operation and 24h after operation, the changes of T lymphocyte subsets （ CD3＋ , CD4＋ , CD4＋/CDs ） were measured, and the postoperative complications were recorded. The patients were followed up for one year, the survival rate and recurrence rate were recorded. Results There was no statistically significant difference in the number of lymph node dissection between the two groups（ t = 1. 023 ,P 〉 0. 05 ）. The operation time of the observation group was significantly longer than that of the control group（t =6,479,P 〈0.05） ,the amount of bleeding of the observation group was significantly less than that of the control group, the postoperative drainage time and ambulation time of the observation group were significantly shorter than those of the control group, the pain score of the observation group was lower than that of the control group, the differences were statistically significant （ t = 17.081,16. 040,39. 443,21. 237, all P 〈 0.05 ）. After operation,the CD3 , CD4＋ , CD4＋/CDs in the two groups were significantly reduced compared with before operation （ observation group： t = 5. 591,5,300,4. 300 ; the control group ： t = 10.450,10. 735,4. 883, all P 〈 0.05 ）, the CD3＋ , CD4＋ , CD4＋/ CD8＋ of the observation group were significantly higher than those of the control group [ （ 58.95 ± 7.58 ） % vs. （52,42±7.52）% ,（34.83 ±3.75）% vs. （30.07 ±3.12）%, （1.21 ±0. 17） vs. （1.15 ±0.13）,t =4. 931, 7. 867,2. 260, all P 〈 0.0
作者
何理祥
郭圣聪
许波涛
He Lixiang;Guo Shengcong;Xu Botao.(Department of Cardio - Thoracic Surgery, the People ＇s Hospital of Zhuji , Zhuji , Zhejiang 511800, China)
出处
《中国基层医药》
CAS
2018年第9期1145-1148,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
癌
非小细胞肺
胸腔镜检查
胸外科手术
电视辅助
Carcinoma,non-small-cell lung
Thoracoscopy
Thoracic surgery,video-assisted
