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目的对比观察全胸腹腔镜肺叶切除与开胸肺叶切除治疗Ⅰ、Ⅱ期非小细胞肺癌的临床效果。方法收集2014年6月—2015年6月期间行手术治疗的110例Ⅰ、Ⅱ期非小细胞肺癌患者的临床资料,根据患者选择术式的不同分为观察组(n=55)和对照组(n=55),观察组采用全胸腔镜肺叶切除,对照组采用开胸肺叶切除,对比观察两组患者手术时间、术中出血量、术中淋巴结清扫数目等术中指标,观察引流管留置时间、总引流量、术后首次排气时间、术后肺炎发生率、术后1年生存率等术后指标,均行统计学对比。结果观察组患者手术时间(114.5±12.7)min,术中出血量(96.4±12.6)ml,引流管留置时间(3.5±1.7)d、总引流量(480.4±65.4)ml、术后首次排气时间(22.4±2.4)h、术后肺炎发生率3.6%(2/55),对照组患者手术时间(133.6±20.5)min,术中出血量(140.6±22.9)ml,引流管留置时间(5.6±2.5)d、总引流量(693.6±105.1)ml、术后首次排气时间(31.8±5.0)h、术后肺炎发生率7.3%(4/55),两组相比,差异均存在统计学意义(P<0.05);观察组患者术后1年生存率92.3%(51/55),淋巴结清扫数目(10.4±2.9)个,对照组患者术后1年生存率90.9%(50/55),淋巴结清扫数目(10.8±3.0)个,两组相比,差异无统计学意义(P>0.05)。结论采用全胸腔镜性肺叶切除治疗Ⅰ、Ⅱ期非小细胞肺癌,临床效果确切,不仅能够取得与开胸手术相近的治疗效果,还缩短了手术时间,降低了手术副损伤,大大提高了患者的术后生活质量,值得临床推广应用。
Objective To compare the clinical effects of total abdominal laparoscopic lobectomy and open lobectomy for patients with stage I and II non-small cell lung cancer. Methods The clinical data of 110 patients with stage Ⅰ and Ⅱ non-small cell lung cancer who underwent surgery between June 2014 and June 2015 were collected and divided into observation group (n = 55) and control group (n = 55). The thoracoscopic lobectomy was performed in the observation group. Thoracotomy lobectomy was performed in the control group. The intraoperative indexes such as operation time, intraoperative blood loss and the number of lymph node dissection in the two groups were compared. Time, total drainage volume, postoperative first exhaust time, postoperative pneumonia incidence, postoperative 1 year survival rate and other postoperative indicators, were statistically compared. Results The operation time of the observation group (114.5 ± 12.7) min, intraoperative blood loss (96.4 ± 12.6) ml, drainage tube indwelling time (3.5 ± 1.7) d, total drainage volume (480.4 ± 65.4) ml, (22.4 ± 2.4) h, the incidence of postoperative pneumonia was 3.6% (2/55), the control group was operated on for 133.6 ± 20.5 min, the blood loss was 140.6 ± 22.9 ml, the drainage tube retention time was 5.6 ± 2.5) d, the total drainage volume (693.6 ± 105.1) ml, the first postoperative exhaust time (31.8 ± 5.0) h and postoperative pneumonia incidence 7.3% (4/55) (P0.05). The 1-year survival rate was 92.3% (51/55) and lymph node dissection number (10.4 ± 2.9) in the observation group. The 1-year survival rate was 90.9% (50/55) in the control group ), The number of lymph node dissection (10.8 ± 3.0), no significant difference between the two groups (P> 0.05). Conclusions Full thoracoscopic lobectomy for stage I and II non-small cell lung cancer has definite clinical effect. It not only achieves the same therapeutic effect as thoracotomy, but also shortens the operation time, reduces the operation side injury and greatly improves the patients Postoperative quality of life, it is worth clinical application.