| 韩 浩,于 奇,陶 宇,缪 军,许 峰,刘永靖.单操作孔胸腔镜单向式肺叶切除术临床分析[J].,2023,(1):87-92 |
| 单操作孔胸腔镜单向式肺叶切除术临床分析 |
| Clinical Analysis of Single-direction Uniportal Thoracoscopic Pilmonary Lobectomy |
| 投稿时间：2022-04-25 修订日期：2022-05-21 |
| DOI：10.13241/j.cnki.pmb.2023.01.017 |
| 中文关键词: 单向式 单操作孔 胸腔镜 肺叶切除术 肺癌 临床效果 |
| 英文关键词: Single-direction Uniportal Thoracoscopic Pilmonary lobectomy Llung cancer Clinical effect |
| 基金项目:安徽省重点研究和开发计划项目(1804h08020284) |
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| 中文摘要: |
| 摘要 目的：对比研究单操作孔胸腔镜单向式肺叶切除术与单操作孔胸腔镜常规肺叶切除术的临床效果。方法：选取我院2018年4月至2022年1月早期非小细胞肺癌患者60例，根据手术方式不同分为观察组（30例）和对照组（30例），观察组行单操作孔胸腔镜单向式肺叶切除术，对照组行单操作孔胸腔镜常规肺叶切术。比较两组手术相关指标、术后疼痛情况、肺功能、炎症因子以及并发症。结果：两组患者淋巴结清扫个数、胸腔引流量比较，差异无统计学意义（P＞0.05），观察组手术时间、术中出血量、住院时间均少于对照组，P＜0.05。两组患者手术前视觉模拟评分（VAS）无统计学意义（P＜0.05），两组患者术后1 d、3 d VAS上升，术后7 d VAS下降（P＜0.05），观察组术后1 d、3 d VAS低于对照组（P＜0.05）。两组患者术前一秒用力呼气容积（FEV1）、用力肺活量（FVC）、FEV1/FVC无差异，两组患者术后1 m、3 m FEV1、FVC、FEV1/FVC先下降后上升，差异有统计学意义（P＜0.05）。两组患者术前C反应蛋白（CPR）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）无统计学意义（P＞0.05），术后1 d、3 d CPR、TNF-α、IL-6先下降后上升（P＜0.05），且观察组患者1 d、3 d CPR、TNF-α、IL-6均低于对照组（P＜0.05）。两组患者并发症比较无统计学差异（P＞0.05）。结论：单操作孔胸腔镜单向式肺叶切除术能缩短手术时间、减少术中出血、降低术后疼痛、降低炎症因子，利于康复。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the clinical effect of single-direction uniportal thoracoscopic pilmonary lobectomy. Methods: To select 60 patients with early non-small cell lung cancer who were treated in our hospital from April 2018 to January 2022, and divide them into observation group and control group according to different surgical methods, with 30 cases in each group. single-direction uniportal thoracoscopic pilmonary lobectomy was performed in the observation group and uniportal thoracoscopic pilmonary lobectomy was performed in the control group. Compare the two groups of surgery related indicators, postoperative pain, lung function, inflammatory factors and complications. Results: There was no significant difference in the number of lymph node dissections and thoracic drainage between the two groups of patients (P>0.05). The operation time, intraoperative blood loss, and hospital stay in the observation group were less than those in the control group (P＜0.05). The visual analogue scale (VAS) of the two groups of patients before operation was not statistically significant(P＜0.05). The VAS of the two groups increased at 1 d and 3 d after surgery. VAS decreased on the 7th day, and the difference was significant(P<0.05). The VAS of the observation group was lower than that of the control group at 1 and 3 days after operation, and the difference was statistically significant(P<0.05). There was no difference in forced expiratory volume (FEV1), forced vital capacity (FVC), FEV1/FVC in the two groups before surgery. The two groups of patients were 1m and 3m FEV1 after surgery, FVC, FEV1/FVC first decreased and then increased, the difference was significant (P<0.05). The preoperative C-reactive protein (CPR), tumor necrosis factor-a (TNF-α), and interleukin-6(IL-6) were not significant in the two groups (P>0.05). Postoperative 1 d, 3 d CPR, TNF-α, IL-6 were first decreased and then increased(P<0.05), and patients 1 d, 3 d CPR, TNF-α, IL-6 were lower than the control group(P＜0.05), and the 1 d and 3 d CPR, TNF-α and IL-6 of the observation group were lower than those of the control group, the difference was significant (P＜0.05). There was no difference in complications between the two groups (P>0.05). Conclusion: Single-direction uniportal thoracoscopic pilmonary lobectomy can shorten the operation time, reduce intraoperative bleeding, reduce postoperative pain, reduce inflammatory factors, and accelerate recovery. |
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