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目的对比分析开胸术和视频协助胸腔镜手术(VATS)两种手术方式在早期肺癌中的临床疗效和并发症。方法该院回顾了从2005年1月1日—2012年10月1日,总共实施了147例实施肺叶切除术治疗早期肺癌的病例,其中对照组88例,采用常传统的开放性开胸手术切除肺癌病灶,观察组59例,采用电视辅助下胸腔镜肺癌切除手术。结果两组患者基础疾病对比,VATS组患者术高血压、慢性肾功能不全、恶性肿瘤发病率和对照组相比,差异有统计学意义(P=0.01)。VATS组患者在ICU监护和对照组相比,时间更短(P=0.02)。VATS组术后患肺炎率更低(P=0.00),胸管放置时间更短,总住院时间更长。在手术时间、失血量、房颤、呼吸机使用时间上,两组差异无统计学意义。两组生存率中位数差异无统计学意义,分别为:开胸组(7.9年)、VATS组(4.6年)。结论对于早期肺癌患者,VATS术与开胸术术后生存率相似,但是VATS减少手术出血量同时减少术后ICU住院时间,手术创伤小,有助于患者术后的康复,术后肺炎发生率更低。
Objective To compare and analyze the clinical curative effect and complications of thoracotomy and video assisted thoracoscopic surgery (VATS) in two types of lung cancer. Methods The hospital reviewed from January 1, 2005 - October 1, 2012, a total of 147 cases of implementation of lobectomy for the treatment of early lung cancer cases, including 88 cases in the control group, the use of conventional open open thoracotomy Excision of lung cancer lesions, the observation group of 59 patients with video-assisted thoracoscopic lung cancer resection. Results Compared with the control group, the difference between the two groups was statistically significant (P = 0.01). The incidence of hypertension, chronic renal insufficiency and malignant tumor in the VATS group was significantly higher than that in the control group. Patients in the VATS group had shorter duration of ICU care compared with the control group (P = 0.02). Patients in the VATS group had a lower rate of postoperative pneumonia (P = 0.00), shorter placement of the chest tube, and longer total hospital stay. In the operation time, blood loss, atrial fibrillation, ventilator use time, there was no significant difference between the two groups. There was no significant difference in median survival between the two groups: thoracotomy group (7.9 years) and VATS group (4.6 years). Conclusions VATS and thoracotomy have similar survival rates in patients with early-stage lung cancer. However, VATS can reduce the amount of surgical bleeding and reduce the postoperative hospital stay of ICU. The surgical trauma is small, which is helpful for postoperative recovery and postoperative pneumonia Lower.