| 师 路,何家杰,王聆宇,付堂清,李林浦.经肋间单孔胸腔镜肺叶切除术对非小细胞肺癌患者肺功能及远期生活质量的影响[J].,2021,(13):2555-2559 |
| 经肋间单孔胸腔镜肺叶切除术对非小细胞肺癌患者肺功能及远期生活质量的影响 |
| Effect of Intercostal Single Port Thoracoscopic Lobectomy on Lung Function and Long-term Quality of Life in Patients with Non-small Cell Lung Cancer |
| 投稿时间：2021-01-05 修订日期：2021-01-27 |
| DOI：10.13241/j.cnki.pmb.2021.13.033 |
| 中文关键词: 经肋间单孔胸腔镜肺叶切除术 非小细胞肺癌 肺功能 生活质量 |
| 英文关键词: Transcostal single port thoracoscopic lobectomy Non-small cell lung cancer Lung function Quality of life |
| 基金项目:四川省医学会科研项目（17P J1901） |
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| 中文摘要: |
| 摘要 目的：探究经肋间单孔胸腔镜肺叶切除术对非小细胞肺癌患者（NSCLC）肺功能及远期生活质量的影响。方法：选取我院2017年1月~2018年1月收治的128例NSCLC患者为研究对象，随机分为对照组和观察组各64例。对照组行传统开胸肺叶切除术，观察组行经肋间单孔胸腔镜肺叶切除术，比较两组患者的围手术期指标（手术时间、切口长度、失血量、引流量、拔管时间、下床活动时间、淋巴结清扫个数）、肺功能（MVV、PEF、FEV1、FVC、FEV1/FVC）、生活质量评分（FACT-L、SF-36）、并发症情况及远期生存率、复发率。结果：观察组手术时间、切口长度、失血量、引流量、拔管时间、下床活动时间均明显低于对照组（P＜0.05），淋巴结清扫个数与对照组比较差异无统计学意义（P＞0.05）。手术前，两组MVV、PEF、FEV1、FVC、FEV1/FVC水平差异均无统计学意义（P＞0.05）；手术后，两组MVV、PEF、FEV1、FVC、FEV1/FVC水平均有下降（P＜0.05），且观察组MVV、PEF、FEV1、FVC、FEV1/FVC水平均明显高于对照组（P＜0.05）。手术前，两组FACT-L、SF-36评分差异均无统计学意义（P＞0.05）；手术后，两组FACT-L、SF-36评分均有提高（P＜0.05），且观察组FACT-L、SF-36评分均明显高于对照组（P＜0.05）。观察组并发症发生率为6.25%，明显低于对照组20.31%，差异有统计学意义（P＜0.05）。观察组术后2年生存率为98.41%，明显高于对照组79.36%，差异有统计学意义（P＜0.05）。观察组复发率为4.68%，明显低于对照组17.46%，差异有统计学意义（P＜0.05）。结论：经肋间单孔胸腔镜肺叶切除术用于治疗NSCLC能够降低患者围手术期的风险，提高肺功能水平，降低术后并发症的发生，还可以改善远期生活质量，减少复发、提高生存率，值得临床推广。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the effect of intercostal single port thoracoscopic lobectomy on lung function and long-term quality of life in patients with non-small cell lung cancer(NSCLC). Methods: 128 cases of NSCLC patients in our hospital from January 2017 to January 2018 were selected as the research objects and randomly divided into the control group and the observation group with 64 cases in each group. The control group was treated with traditional thoracotomy lobectomy, and the observation group was treated with intercostal single port thoracoscopic lobectomy. The perioperative indexes (operation time, incision length, blood loss, drainage volume, extubation time, ambulation time, number of lymph node dissection), lung function (MVV, PEF, FEV1, FVC, FEV1/FVC), quality of life score(FACT-L, SF-36), complications, long-term survival rate and recurrence rate were compared between the two groups. Results: The operation time, incision length, blood loss, drainage volume, extubation time and ambulation time in the observation group were significantly lower than those in the control group (P<0.05), and there was no significant difference in the number of lymph node dissection between the observation group and the control group(P>0.05). Before operation, there was no significant difference in MVV, PEF, FEV1, FVC, FEV1/FVC levels between the two groups(P>0.05); after operation, the levels of MVV, PEF, FEV1, FVC, FEV1/FVC in the two groups were decreased (P<0.05), and the levels of MVV, PEF, FEV1, FVC, FEV1/FVC in the observation group were significantly higher than those in the control group(P<0.05). Before operation, there was no significant difference in the scores of FACT-L and SF-36 between the two groups(P>0.05); after operation, the scores of FACT-L and SF-36 in the two groups were improved(P<0.05), and the scores of FACT-L and SF-36 in the observation group were significantly higher than those in the control group(P<0.05). The incidence of complications in the observation group was 6.25%, which was significantly lower than that in the control group(20.31%)(P<0.05). The 2-year survival rate of the observation group was 98.41%, which was significantly higher than that of the control group(79.36%)(P<0.05). The recurrence rate of the observation group was 4.68%, which was significantly lower than that of the control group (17.46%)(P<0.05). Conclusion: Transcostal single port thoracoscopic lobectomy for the treatment of NSCLC can reduce the risk of patients during the perioperative period, improve the level of lung function, reduce the incidence of postoperative complications, and can also improve the long-term quality of life, reduce the recurrence and improve the survival rate, which is worthy of clinical promotion. |
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