| 邱琼香,李彩莲,冯雪花,李文娟,林 珊,陈献珊.单孔与三孔胸腔镜肺叶切除术对周围型肺癌患者炎症因子、T淋巴细胞亚群和生活质量的影响[J].,2021,(9):1767-1771 |
| 单孔与三孔胸腔镜肺叶切除术对周围型肺癌患者炎症因子、T淋巴细胞亚群和生活质量的影响 |
| Effects of Single Hole and Three Hole Thoracoscopic Lobectomy on Serum Inflammatory Factors and Peripheral Blood T Lymphocyte Subsets and Quality of Life in Patients with Peripheral Lung Cancer |
| 投稿时间：2020-11-04 修订日期：2020-11-28 |
| DOI：10.13241/j.cnki.pmb.2021.09.037 |
| 中文关键词: 单孔胸腔镜肺叶切除术 三孔胸腔镜肺叶切除术 周围型肺癌 炎症因子 T淋巴细胞亚群 生活质量 |
| 英文关键词: Single hole thoracoscopic lobectomy Three hole thoracoscopic lobectomy Peripheral lung cancer Inflammatory factors T lymphocyte subsets Quality of life |
| 基金项目:海南省社会发展专项基金项目（SQ2016SHFZ0035） |
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| 中文摘要: |
| 摘要 目的：探讨单孔与三孔胸腔镜肺叶切除术对周围型肺癌患者炎症因子、生活质量、T淋巴细胞亚群的影响。方法：回顾性分析我院于2016年12月~2019年10月间收治的80例周围型肺癌患者的临床资料。根据手术方式的不同将其分为A组（n=39，行三孔胸腔镜肺叶切除术）、B组（n=41，单孔胸腔镜肺叶切除术），比较两组患者围术期指标、血清炎症因子、外周血T淋巴细胞亚群、生活质量及并发症情况。结果：两组术中淋巴结清扫个数、术中出血量对比无差异（P>0.05），B组术后引流管拔除时间、切口长度短于A组，手术时间长于A组，视觉模拟评分法（VAS）评分低于A组（P<0.05）。两组术后并发症发生率比较无差异（P>0.05）。两组术后3 d、术后7 d降钙素原（PCT）、肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）及CD8+水平均较术前升高，术后7 d上述指标较术后3 d降低，且B组术后3 d、术后7 d上述指标水平低于A组（P<0.05）。两组术后3 d、术后7 d的CD4+、CD4+/CD8+均较术前降低，术后7 d上述指标较术后3 d升高，且B组术后3 d、术后7 d上述指标水平高于A组（P<0.05），两组术后3个月情感状况、功能状况、社会/家庭状况、附加状况、身体状况评分均升高，且B组高于A组（P<0.05）。结论：与三孔胸腔镜肺叶切除术相比，采用单孔胸腔镜肺叶切除术治疗周围型肺癌，可获得与其相当的治疗效果，同时还可减少术中损伤，降低炎症因子水平，减轻免疫抑制和炎症应激，提高患者生活质量，且不增加并发症发生率。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of single hole and three hole thoracoscopic lobectomy on inflammatory factors, quality of life and T lymphocyte subsets in patients with peripheral lung cancer. Methods: The clinical data of 80 patients with peripheral lung cancer who were admitted to our hospital from December 2016 to October 2019 were analyzed retrospectively. According to the different operation methods, they were divided into group A(n=39, three hole thoracoscopic lobectomy) and group B (n=41, single hole thoracoscopic lobectomy). The perioperative indexes, serum inflammatory factors, peripheral blood T lymphocyte subsets, quality of life and complications of the two groups were compared. Results: There was no significant difference between the two groups in the number of lymph node dissection and the amount of intraoperative hemorrhage(P>0.05). The time of drainage tube removal after operation and incision length were shorter than those of group A, the operation time of group B was longer than that of group A, and visual analogue scale (VAS) score was lower than that of group A (P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). The levels of procalcitonin (PCT), tumor necrosis factor-α(TNF-α), C-reactive protein (CRP) and CD8+ of the two groups at 3d after operation and 7 d after operation were higher than those before operation, the above indexes at 3 d after operation were lower than those after operation 7 d, and the levels of above indexes of group B at 3 d after operation and 7 d after operation were lower than those of the group A (P<0.05). The CD4+ and CD4+/CD8+ of the two groups at 3 d after operation and 7 d after operation were lower than those before operation, the above indexes at 3 d after operation were higher than those after operation 7 d, and the levels of above indexes of group B at 3 d after operation and 7 d after operation were higher than those of the group A (P<0.05). The scores of emotional status, functional status, social/family status, additional status and physical status of the two groups increased at 3 months after operation, and the scores in group B were higher than those in group A (P<0.05). Conclusion: Compared with the three hole thoracoscopic lobectomy, the single hole can achieve the same therapeutic effect in peripheral lung cancer, at the same time, it can reduce the intraoperative injury, reduce the immunosuppression and inflammatory stress, improve the quality of life of patients, and do not increase the incidence rate of complications. |
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