摘要
目的探究CT引导下Hook-wire定位辅助胸腔镜手术(TS)治疗早期肺癌的疗效。方法依据不同手术方法将本院2017年4月~2021年5月收治的早期肺癌患者80例分为定位组(41例)和胸腔镜组(39例)。胸腔镜组给予TS,定位组在实施TS前以CT引导下Hook-wire进行定位。对比两组手术指标、手术前后细胞免疫功能(T淋巴细胞CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、肺功能[一氧化碳弥散量(DLCO)、用力肺活量(FVC)、每分钟最大通气量(MVV)]、并发症及复发情况。结果定位组术中出血量少于胸腔镜组,手术、术后引流、住院时间均短于胸腔镜组,差异有统计学意义(P<0.05);术后3d定位组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于胸腔镜组,CD8+水平低于胸腔镜组,差异均有统计学意义(P<0.05);术后1个月定位组FVC、DLCO、MVV高于胸腔镜组,差异均有统计学意义(P<0.05);定位组切缘阳性率(2.44%)、并发症总发生率(7.32%)及随访1年复发率(2.63%)与胸腔镜组(10.26%、15.38%、17.65%)比较差异无统计学意义(P>0.05)。结论早期肺癌患者实施TS前在CT引导下Hook-wire进行定位能降低操作难度,优化手术情况,减轻肺功能、免疫功能损伤。
Objective To investigate the efficacy of CT-guided Hook-wire localization-assisted thoracoscopic surgery(TS)in the treatment of early-stage lung cancer.Methods 80 patients with early-stage lung cancer admitted to our hospital from April 2017 to May 2021 were divided into localization group(41 patients)and thoracoscopic group(39 patients)according to different surgical methods.The thoracoscopic group was given TS,and the localization group was localized with CT-guided Hook-wire before performing TS.The surgical indexes,cellular immune function[T lymphocytes CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)],lung function[carbon monoxide diffusion volume(DLCO),force spirometry(FVC),maximum ventilation per minute(MVV)],and complications,recurrence were compared between the two groups before and after surgery.Results Intraoperative bleeding was less in the localization group than in the thoracoscopic group,and the duration of surgery,postoperative drainage,hospital stay was shorter than in the thoracoscopic group,and the differences were statistically significant(P<0.05);CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)levels were higher in the localization group than in the thoracoscopic group and CD8+levels were lower than in the thoracoscopic group 3 d after surgery,and the differences were statistically significant(P<0.05).FVC,DLCO,and MVV were higher in the localization group than in the thoracoscopic group at 1 month after surgery,and the differences were statistically significant(P<0.05);There were no significant differences(P>0.05)in the positive incision margin rate(2.44%),the overall complication rate(7.32%)and the recurrence rate at 1 year follow-up(2.63%)in the localization group compared with the thoracoscopic group(10.26%,15.38%,17.65%).Conclusion Positioning with CT-guided Hook-wire before performing TS in patients with early stage lung cancer can reduce the difficulty of operation,optimize the surgical situation,and reduce lung function and immune function damage.
作者
李军伟
程再轩
王瑞
Li Junwei;Cheng Zaixuan;Wang Rui(Cardio-Thoracic Surgery,Xinyang Central Hospital,Xinyang 464000,China)
出处
《华北理工大学学报（医学版）》
2023年第2期113-117,144,共6页
Journal of North China University of Science and Technology：Health Sciences Edition
