目的探讨全胸腔镜肺叶切除术与开胸肺叶切除术对患者围手术期免疫功能的影响。方法 80例肺叶切除患者随机分为两组,A组35例,采用全胸腔镜肺叶切除术,B组45例,采用开胸肺叶切除术。比较两组手术资料,并采用流式细胞仪检测手术前后外周血CD3+、CD4+、CD8+、CD4+/CD8+及NK细胞水平。结果 A组术中失血量、术后胸管引流时间和引流量、住院时间及术后疼痛时间均少于B组(P<0.05)。术后1d,两组患者CD3+、CD4+、CD4+/CD8+及NK细胞活性较术前均显著降低(P<0.05);术后7d,A组CD3+、CD4+、CD4+/CD8+及NK细胞活性恢复至术前水平。结论与开胸肺叶切除术相比,全胸腔镜肺叶切除术创伤小、恢复快,对患者免疫功能影响小。 Objective To investigate the effect of thoracoscopic lobectomy and open thoracic lobectomy on perioperative immune function in patients. Methods Eighty patients with lobectomy were randomly divided into two groups. 35 patients in group A were treated with thoracoscopic lobectomy. 45 patients in group B were treated with open-lung lobectomy. The surgical data were compared between the two groups, and the levels of CD3+, CD4+, CD8+, CD4+/CD8+, and NK cells in the peripheral blood before and after surgery were measured by flow cytometry. Results The blood loss, chest drainage time, drainage volume, length of hospital stay and postoperative pain time in group A were all less than those in group B (P<0.05). At 1d after surgery, the activity of CD3+, CD4+, CD4+/CD8+, and NK cells in both groups was significantly lower than before surgery (P<0.05). At 7 days after surgery, the activity of CD3+, CD4+, CD4+/CD8+, and NK cells in group A returned to surgery. Front level. Conclusion Compared with open thoracic lobectomy, thoracoscopic lobectomy has less trauma and rapid recovery, and has little effect on patients’ immune function.