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目的分析胸腔镜下单孔手术治疗肺癌的安全性及临床疗效。方法选取肺癌患者82例,按患者意愿将其分为治疗组和对照组。治疗组41例,采用单孔胸腔镜肺癌根治术治疗;对照组41例,采用胸腔镜肺癌根治术治疗。观察记录并比较两组患者清扫淋巴结的数目、术中出血量、手术时长、术后放置引流管时长、住院时长、术后胸腔引流量,术后第1、3、7天及第1个月时视觉模拟疼痛评分,术后并发症如切口感染、乳糜胸、肺不张、心律失常、喉返神经损伤、肺栓塞、肺部感染、皮下气肿、死亡等发生率。结果两组患者手术均进行顺利,治疗组切口感染、乳糜胸、肺不张、心律失常、喉返神经损伤、肺栓塞、肺部感染、皮下气肿、死亡等并发症发生率高于对照组,但差异未见统计学意义(P>0.05);经治疗两组清扫淋巴结的数目、术中出血量、手术时长比较差异未见统计学意义(P>0.05);治疗组术后放置引流管时长、住院时长、术后胸腔的引流量均显著少于对照组(P<0.05);术后第1天时视觉模拟疼痛评分两组比较差异未见统计学意义(P>0.05),术后第3、7天及第1个月时治疗组视觉模拟疼痛评分显著少于对照组(P<0.05)。结论单孔胸腔镜手术治疗肺癌显著缩短放置引流管时长、术后胸腔的引流量,创口小,可减少手术风险,缩短恢复时间,减轻手术带来的创伤,缩短住院时长,减少患者经济负担,不会增加术后切口感染、乳糜胸、肺不张、心律失常、喉返神经损伤、肺栓塞、肺部感染、皮下气肿、死亡等并发症发生率,临床效果显著,值得应用于临床治疗。
Objective To analyze the safety and clinical efficacy of thoracoscopic single hole surgery in the treatment of lung cancer. Methods 82 patients with lung cancer were selected and divided into treatment group and control group according to their wishes. Thirty-one patients in the treatment group were treated with single-hole thoracoscopic lung cancer radical mastectomy. In the control group, 41 patients were treated with thoracoscopic lung cancer radical mastectomy. The number of lymph nodes dissected, the amount of bleeding during operation, the duration of operation, the length of drainage tube after operation, the length of hospital stay, the amount of chest drainage, the first, third and seventh days and the first month after operation were observed and recorded. Visual analogue pain score, postoperative complications such as incision infection, chylothorax, atelectasis, arrhythmia, recurrent laryngeal nerve injury, pulmonary embolism, pulmonary infection, subcutaneous emphysema, death and other incidence. Results The operation of the two groups was successful. The incision infection in the treatment group was higher than that in the control group in the incidence of chylothorax, atelectasis, arrhythmia, recurrent laryngeal nerve injury, pulmonary embolism, pulmonary infection, subcutaneous emphysema and death , But the difference was not statistically significant (P> 0.05). There was no significant difference between the two groups in the number of lymph nodes dissection, intraoperative blood loss and operation duration (P> 0.05) (P <0.05). On the first day after operation, there was no significant difference between the two groups in visual analogue pain score (P> 0.05). After operation, Visual analog pain scores in the treatment group were significantly less than those in the control group on days 3, 7 and 1 (P <0.05). Conclusions The single hole thoracoscopic surgery for lung cancer significantly shortened the drainage tube placement time, postoperative thoracic drainage volume, small wound, can reduce the surgical risk and shorten the recovery time, reduce the trauma caused by surgery, shorten the length of hospital stay and reduce the financial burden on patients, Will not increase the incidence of postoperative wound infection, chylothorax, atelectasis, arrhythmia, recurrent laryngeal nerve injury, pulmonary embolism, pulmonary infection, subcutaneous emphysema, death and other complications, the clinical effect is significant and deserves to be used in clinical treatment .