摘要
目的:探讨胸腔镜下肺楔形切除术用于老年肺癌的效果及对呼吸功能、应激指标的影响。方法:选取2020年1月—2023年1月无锡市第二人民医院收治的102例老年肺癌患者,按照随机数表法分为两组,研究组(n=51)采用胸腔镜下肺楔形切除术,对照组(n=51)采用胸腔镜下常规肺叶切除术,对比两组围手术期指标(手术时间、术中出血量、胸引流管留置时间、引流量、住院时间)、呼吸功能指标如第1秒用力呼气容积(FEV_(1))、一秒率[FEV_(1)/用力肺活量(FVC)%]、最大呼气流量(PEF)、应激指标[皮质醇(Cor)、去甲肾上腺素(NE)、血管紧张素Ⅱ(AT-Ⅱ)、淀粉样蛋白A(SAA)]、并发症(切口感染、肺漏气、乳糜胸)。结果:研究组胸引流管留置时间、住院时间均短于对照组,且术中出血量、引流量低于对照组,差异有统计学意义(P<0.05),两组手术时间对比,差异无统计学意义(P>0.05);术后3个月,两组FEV_(1)、FEV_(1)/FVC%、PEF较术前均降低,但研究组FEV_(1)、FEV_(1)/FVC%、PEF均高于对照组,差异有统计学意义(P<0.05);术后即刻,两组Cor、NE、AT-Ⅱ、SAA水平均升高,但研究组Cor、NE、AT-Ⅱ、SAA水平均低于对照组,差异有统计学意义(P<0.05);研究组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:在老年肺癌患者中行胸腔镜下肺楔形切除术能够获得较好的疗效,且对应激水平的影响较小,减少术后肺功能损伤程度,术后并发症少。
Objective:To explore the effect of lung wedge resection under thoracoscopy in elderly lung cancer patients and its influence on respiratory function and stress indicators.Method:A total of 102 elderly patients with lung cancer admitted to Wuxi Second People's Hospital from January 2020 to January 2023 were selected,they were randomly divided into two groups by random number table method.The study group(n=51)was treated with lung wedge resection under thoracoscopy,and the control group(n=51)was treated with routine lobectomy under thoracoscopy,The perioperative indicators(operation time,intraoperative bleeding,chest drainage tube indwelling time,drainage flow,hospital stay),respiratory function indicators such as forced expiratory volume in one second(FEV_(1)),one second rate[FEV_(1)/forced vital capacity(FVC)%],peak expiratory flow(PEF),stress indicators[cortisol(Cor),norepinephrine(NE),angiotensinⅡ(AT-Ⅱ),serum amyloid A(SAA)],complications(incision infection,lung leakage,chylothorax)were compared between the two groups.Result:The placement time and hospitalization time of the thoracic drainage tube in the study group were shorter than those in the control group,the intraoperative bleeding volume and drainage volume were lower than those in the control group,the differences were statistically significant(P<0.05).There was no statistically significant difference in surgical time between the two groups(P>0.05).Three months after surgery,FEV_(1),FEV_(1)/FVC%and PEF in both groups were lower,but FEV_(1),FEV_(1)/FVC%and PEF in the study group were higher than those in the control group,the differences were statistically significant(P<0.05).Immediately after surgery,the levels of Cor,NE,AT-Ⅱ,and SAA in both groups increased with statistical significance,but the levels of Cor,NE,AT-Ⅱ,and SAA in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).The incidence of complications in the study group was lower than that in the control group,and the differen
作者
吴玮
陈斌
WU Wei;CHEN Bin(Wuxi Second People's Hospital,Wuxi 214000,China;不详)
出处
《中外医学研究》
2024年第4期34-38,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
老年肺癌
胸腔镜
肺楔形切除术
呼吸功能
应激水平
Senile lung cancer
Thoracoscopy
Lung wedge resection
Respiratory function
Stress level
