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目的比较电视胸腔镜手术(video-assisted thoracoscopic surgery,VATS)与小切口开胸手术(minimalincision thoracotomy,MIT)治疗临床早期非小细胞肺癌(non-small cell lung cancer,NSCLC)及其两种手术方式术后患者生活质量的变化特点。方法我们的研究为前瞻性随机对照临床研究生活质量的阶段分析。共纳入2008年1月1日至2011年12月10日中山大学肿瘤防治中心收治的106例NSCLC患者(男57例、女49例,平均年龄57.60岁),采用单中心、双盲试验的随机分组方法分为VATS组(n=57)和MIT组(n=49)。利用肺癌症状量表(LungCancer Symptom Scale,LCSS)评估两组患者术前、术后第1、3、6、9和12个月的生活质量。结果两组患者在年龄、性别、肿瘤所在肺叶、肿瘤病理分期、病理类型、术后并发症、肿瘤直径、手术时间、术中出血量和胸腔引流管置留时间等方面差异无统计学意义(P>0.05)。术后6个月中,VATS组内各指标评分与术前评分的差异无统计学意义(P>0.05);MIT组内术后1个月食欲[(1.04±0.71)vs.(2.00±0.83),F=6.357,P=0.021]、疲劳[(4.55±1.17)vs.(10.19±2.10),F=4.721,P=0.043]、气促[(2.18±0.86)vs.(10.26±2.05),F=10.020,P=0.005]及疾病对正常生活的影响[(5.16±1.70)vs.(17.60±3.17),F=12.319,P=0.002]评分与术前比较,差异有统计学意义。结论VATS行早期肺癌根治术后患者生活质量与术前无明显差异,术后恢复平稳。
Objective To compare the efficacy of video-assisted thoracoscopic surgery (VATS) and minimal incision thoracotomy (MIT) in the treatment of early-stage non-small cell lung cancer (NSCLC) and its two surgical methods Postoperative patients with changes in the quality of life characteristics. Methods Our study was a prospective, randomized, controlled clinical study of the quality of life stage analysis. A total of 106 NSCLC patients (57 males and 49 females, average age 57.60 years) admitted to Sun Yat-sen University Cancer Center from January 1, 2008 to December 10, 2011 were enrolled in the study. Grouping methods were divided into VATS group (n = 57) and MIT group (n = 49). The quality of life at 1, 3, 6, 9 and 12 months before and after surgery was assessed using the Lung Cancer Symptom Scale (LCSS). Results There was no significant difference between the two groups in terms of age, sex, lung lobe tumor location, pathological type, pathological type, postoperative complications, tumor diameter, operation time, intraoperative blood loss and pleural drainage tube residence time P> 0.05). There was no significant difference between the VATS group and the preoperative score in the 6 months after operation (P> 0.05). The appetite in the VATS group [(1.04 ± 0.71) vs. (2.00 ± 0.83 , F = 6.357, P = 0.021], fatigue (4.55 ± 1.17 vs. 10.29 ± 2.10, F = 4.721, P = 0.043) , F = 10.020, P = 0.005], and the influence of the disease on normal life [(5.16 ± 1.70) vs. (17.60 ± 3.17), F = 12.319, P = 0.002] were significantly different from those before operation. Conclusions There is no significant difference in the quality of life between the patients with VATS and the radical resection of lung cancer before operation. The postoperative recovery is stable.