摘要
目的研究胸腔镜肺段切除术(TS)治疗非小细胞肺癌(NSCLC)的临床效果及其对血清乳酸脱氢酶(LDH)、胃泌素释放肽前体(ProGRP)以及神经元特异性烯醇化酶(NSE)的影响。方法前瞻性选择2019年1月至2021年10月昆山市第一人民医院行手术治疗的90例NSCLC患者,依照随机数字表法将其分为TS组(n=45)与胸腔镜肺叶切除术(TL)组(n=45)。TS组行TS治疗,TL组行TL治疗。观察两组术中出血量、淋巴结清扫数目、手术时间、术后引流量、胸腔引流时间及术后住院时间等围手术期相关指标;术前、术后6个月第一秒用力呼气容积占预计值的百分比(FEV1%)、用力肺活量占预计值的百分比(FVC%)等肺功能指标;术前、术后7 d血清LDH、ProGRP、NSE水平;术后并发症等指标。结果TS组手术时间为(195.75±22.74)min,大于TL组[(183.79±21.83)min],术中出血量、术后引流量、拔管时间及术后住院时间为(73.85±7.60)mL、(690.84±72.09)mL、(4.05±0.43)d、(6.68±0.69)d,均小于TL组[(82.95±8.52)mL、(1317.08±138.07)mL、(5.73±0.59)d、(7.63±0.81)d],差异均有统计学意义(P<0.05)。两组淋巴结清扫数目比较,差异无统计学意义(P>0.05)。术后6个月,TS组FEV1%、FVC%为(83.75±8.71)%、(83.01±8.65)%,均高于TL组[(75.95±7.82)%、(74.86±7.72)%],差异均有统计学意义(P<0.05)。术后6个月,两组血清LDH、ProGRP、NSE水平比较,差异均无统计学意义(P>0.05)。TS组术后并发症发生率为2.22%,低于TL组(20.00%),差异有统计学意义(P<0.05)。结论TS治疗NSCLS可在有效切除病灶的同时尽量减少肺组织损伤,对于保留患者肺功能,减少术后并发症,促进术后康复,降低血清LDH、ProGRP、NSE水平,具有积极作用。
Objective To study clinical effect of thoracoscopic segmentectomy(TS)on non-small cell lung cancer(NSCLC)and its effect on serum lactic dehydrogenase(LDH),pro-gastrin-releasing peptide(ProGRP)and neuronspecific enolase(NSE).Methods A total of 90 patients with NSCLC who underwent surgical treatment in Kunshan First People's Hospital from January 2019 to October 2021 were prospectively selected and divided into TS group(n=45)and thoracothoracoscopic lobectomy(TL)group(n=45)according to random number table method.TS group received TS treatment,and TL group received TL treatment.Perioperative related indexes,such as intraoperative blood loss,number of lymph nodes dissected,operative time,postoperative drainage volume,duration of thoracic drainage and postoperative hospital stay were observed.Forced vital capacity rate of one second%(FEV1%),Forced vital capacity%(FVC%)and other lung function indexes before and 6 months after operation;Serum LDH,ProGRP and NSE levels before and 7 days after operation.Postoperative complications and other indicators.Results The operative time of TS group was(195.75±22.74)min,which was longer than that of TL group[(183.79±21.83)min],and the intraoperative blood loss,postoperative drainage volume,extubation time and postoperative hospital stay were(73.85±7.60)mL,(690.84±72.09)mL,(4.05±0.43)d,(6.68±0.69)d,which were shorter than that of TL group[(82.95±8.52)mL,(1317.08±138.07)mL,(5.73±0.59)d,(7.63±0.81)d],the differences were statistically significant(P<0.05).There was no difference in the number of dissected lymph nodes between the two groups(P>0.05).6 months after operation,FEV1%and FVC%in TS group were(83.75±8.71)%,(83.01±8.65)%,which were higher than those in TL group[(75.95±7.82)%,(74.86±7.72)%],the differences were statistically significant(P<0.05).There were no differences in serum LDH,ProGRP and NSE levels between the two groups 6 months after operation(P>0.05).The incidence of postoperative complications in TS group was 2.22%,which was lower than that in TL group(20.
作者
张亚年
张璐
范心庭
ZHANG Ya-nian;ZHANG Lu;FAN Xin-ting(Department of Cardiothoracic Surgery,Kunshan First People's Hospital,Kunshan Jiangsu 215300,China.)
出处
《临床和实验医学杂志》
2022年第19期2062-2066,共5页
Journal of Clinical and Experimental Medicine
基金
2020年姑苏卫生人才培养项目(编号:GSWS2020113)
上海吴孟超医学科技基金会,临床医学基础与应用研究专项基金(编号:JJHXM-2021002)。
