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目的:对比分析传统开胸手术和胸腔镜下肺叶切除对老年性早期周围型肺癌的疗效及生存曲线的差异。方法:选取我院行肺癌手术治疗的患者65例,均为周围型肺癌。采用非随机对照方法,将患者随机分为传统开胸手术组和胸腔镜组,其中开胸手术组34例,胸腔镜组31例。按照既定分组方案实施手术,对比分析两组患者一般属性资料、手术相关指标;术后随访至2016年6月,采用Kaplan-Meier法对比2组患者5年总生存率(OS)、无复发生存率(RFS)。结果:胸腔镜手术组手术时间明显长于开胸组(p<0.05)。胸腔镜组拔出胸腔引流管天数明显缩短(p<0.05)。胸腔镜组术中出血量少于开胸组(p<0.05)。胸腔镜组术后并发症发生率、VAS评分、住院时间低于开胸组(p<0.05)。但胸腔镜组住院总费用多于开胸组(p<0.05)。开胸组组5年RFS为65.27%,胸腔镜组67.13%,差异无统计学意义(p>0.05)。开胸组患者5年OS为53.73%,胸腔镜组为55.34%,差异有统计学意义(p<0.05)。结论:相比传统开胸手术,胸腔镜下早期肺癌切除术出血量少,恢复快,术后并发症发生率低,术后5年总生存率高于传统开胸术。
OBJECTIVE: To compare the efficacy and survival curves of traditional thoracotomy and thoracoscopic lobectomy for elderly patients with early-stage peripheral lung cancer. Methods: We selected 65 cases of lung cancer surgery in our hospital, all of which were peripheral lung cancer. Patients were randomly divided into conventional thoracotomy group and thoracoscopic surgery group, including 34 cases of thoracotomy group and 31 cases of thoracoscopy group. According to the established grouping plan, the general attributes and operation-related indexes of the two groups were compared and analyzed. The postoperative follow-up was performed in June 2016. The Kaplan-Meier method was used to compare the 5-year overall survival (OS) and non-recurrence Rate (RFS). Results: The operation time in thoracoscopic surgery group was significantly longer than that in thoracotomy group (p <0.05). The thoracoscopic group had significantly shorter days of pulling out of the chest drainage tube (p <0.05). Thoracic surgery less blood loss than the thoracic group (p <0.05). The postoperative complication rate, VAS score and hospital stay in thoracoscopic group were lower than those in thoracotomy group (p <0.05). However, the total cost of hospitalization in the thoracoscopic group was more than that in the thoracotomy group (p <0.05). The 5-year RFS was 65.27% in thoracotomic group and 67.13% in thoracoscopic group, the difference was not statistically significant (p> 0.05). The 5-year OS was 53.73% in thoracotomy group and 55.34% in thoracoscopic group, the difference was statistically significant (p <0.05). Conclusion: Compared with traditional thoracotomy, the early thoracoscopic lung cancer resection less bleeding, rapid recovery, the incidence of postoperative complications is low, 5-year overall survival rate was higher than the traditional thoracotomy.