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目的探讨不同电视辅助胸腔镜入路肺叶切除术对早期非小细胞肺癌临床效果和术后患者生活质量的影响。方法选择178例Ⅰ期非小细胞肺癌患者,其中男性95例,女性83例;年龄44~80岁。随机分为2组,每组89例。A组给予单操作孔电视辅助胸腔镜肺叶切除术治疗,B组给予单孔电视辅助胸腔镜肺叶切除术治疗。观察2组手术时间、术中失血量、术后引流量、拨除胸腔引流管时间、下床活动时间、淋巴结清扫个数、术后并发症发生率,比较2组术后1、3、7 d时VAS疼痛评分,术前、术后1、2、3、7 d时血清C反应蛋白(CRP)水平,术前1 d和术后1个月、3个月采用肺癌患者癌症治疗功能性量表(FACT-L)评分。结果两组手术时间、术后引流量、拔除引流管时间、下地活动时间、淋巴结清扫个数及并发症发生率(16.85%vs 12.36%)相比较,差异均无统计学意义(P>0.05);B组术中失血量与A组相比较,显著降低(P<0.01)。B组术后1、3、7 d时VAS评分与A组相比较,均显著降低(P<0.05)。B组术后1、2、3、7 d时CRP水平与同期A组相比较,均显著降低(P<0.05)。B组术后1个月FACT-L总分[(91.04±5.83)分]高于同期A组[(86.75±5.25)分](P<0.05),术后3个月FACT-L总分[(95.92±5.72)分]与同期A组[(97.38±5.37)分]相比较,差异无统计学意义(P>0.05)。结论单孔电视辅助胸腔镜肺叶切除术治疗早期非小细胞肺癌可获得与单操作孔电视辅助胸腔镜肺叶切除术同样的手术效果,且可减少手术创伤,减轻患者术后疼痛感,有利于术后生活质量恢复,值得临床推广应用。
Objective To investigate the effect of different video-assisted thoracoscopic lobectomy on the clinical efficacy of early non-small cell lung cancer and postoperative quality of life. Methods 178 patients with stage Ⅰ non-small cell lung cancer were selected, including 95 males and 83 females, aged 44-80 years. Randomly divided into two groups, 89 cases in each group. Group A was given a single-hole video-assisted thoracoscopic lobectomy. Group B was treated with single-hole video-assisted thoracoscopic lobectomy. The operation time, intraoperative blood loss, postoperative drainage volume, the time of removal of chest drainage tube, the time to get out of bed, the number of lymph node dissection, the incidence of postoperative complications were observed and compared between the two groups VAS pain score, preoperative and postoperative 1,2,3,7 d serum C-reactive protein (CRP) levels, 1 d before surgery and 1 month and 3 months after surgery with lung cancer patients with functional therapy Scale (FACT-L) score. Results There were no significant differences in the operation time, the amount of drainage after operation, the drainage time of drainage tube, the time of lower limb movement, the number of lymph node dissection and the incidence of complications (16.85% vs 12.36%) in both groups (P> 0.05) The blood loss in group B was significantly lower than that in group A (P <0.01). Compared with group A, the VAS score of group B at 1, 3 and 7 days after operation was significantly lower (P <0.05). CRP levels in group B at 1, 2, 3 and 7 days after operation were significantly lower than those in group A at the same period (P <0.05). The total score of FACT-L (91.04 ± 5.83) in group B at one month after operation was significantly higher than that in group A (86.75 ± 5.25) at the same period (P0.05) (95.92 ± 5.72) points compared with the same period A group (97.38 ± 5.37) points, the difference was not statistically significant (P> 0.05). Conclusions Single-hole TV-assisted thoracoscopic lobectomy for early non-small cell lung cancer can achieve the same surgical effect as single-hole TV-assisted thoracoscopic lobectomy, and can reduce the surgical trauma and relieve the postoperative pain sensation in patients with early non-small cell lung cancer After the quality of life recovery, it is worth clinical application.