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目的:探讨系统性纵隔淋巴结清扫术对非小细胞肺癌患者预后的影响。方法:选择2007年1月至2009年12月在我院住院的124例非小细胞肺癌患者为研究对象,并将其随机分为对照组和实验组,对照组60例患者采用采样式纵隔淋巴结清扫术(meditational lymph node sampling,LS)治疗,实验组64例患者采用系统纵隔淋巴结清扫术(systematic meditational lymphadenectomy,SML)治疗。比较两组患者的淋巴结清除总数、淋巴结转移数、淋巴结转移率,通过寿命表法和Kaplan-Meier法比较两组患者的累积3年生存率及中位生存时间。结果:两组比较淋巴结转移率无统计学差异,而与对照组相比,实验组术后并发症发生率明显下降,差异具有统计学意义(P<0.05)。对照组和实验组患者的中位生存期、3年生存率分别为20.1和24.2个月、18.75%和43.33%,两组比较差异显著,有统计学意义(P<0.05)。结论:系统性纵隔淋巴结清扫治疗非小细胞肺癌可显著降低患者的淋巴结转移率,并提高患者的3年生存率,延长患者的寿命。
Objective: To investigate the effect of systematic mediastinal lymph node dissection on the prognosis of patients with non-small cell lung cancer. METHODS: A total of 124 patients with NSCLC who were hospitalized in our hospital from January 2007 to December 2009 were selected. They were randomly divided into a control group and an experimental group. 60 patients in the control group were treated with sampled mediastinal lymph nodes. After LS treatment, 64 patients in the experimental group were treated with systematic meditational lymphadenectomy (SML). The total lymph node clearance, lymph node metastasis, and lymph node metastasis rate were compared between the two groups. The cumulative 3-year survival rate and median survival time were compared between the two groups by life table method and Kaplan-Meier method. Results: There was no significant difference in the lymph node metastasis rate between the two groups. Compared with the control group, the incidence of postoperative complications in the experimental group decreased significantly (P<0.05). The median survival time and 3-year survival rate of the control group and the experimental group were 20.1 and 24.2 months, 18.75% and 43.33% respectively. There was a significant difference between the two groups (P<0.05). CONCLUSIONS: Systemic mediastinal lymph node dissection for non-small cell lung cancer can significantly reduce lymph node metastasis, increase 3-year survival, and prolong patient longevity.