刘泉,林春娥,夏道奎
LIU Quan,LIN Chun'e,XIA Daokui

• 1:宜昌市中心人民医院三峡大学第一临床医学院三峡大学心血管病研究所

摘要(Abstract)：

目的:比较胸腔镜下肺癌根治术与开胸手术治疗老年非小细胞肺癌的疗效。方法:120例非小细胞肺癌老年患者均分为观察组和对照组,观察组采用胸腔镜下肺癌根治术,对照组采用开胸手术;比较两组患者的手术时间、术中出血量、术后引流量等手术指标,治疗前和出院时心率(HR)、最大通气量(MVV)、第一秒用力呼气容积(FEV1)。随访3年,比较两组患者无瘤生存率。结果:观察组患者的手术时间显著短于对照组患者(P<0.05),术中出血量及术后引流量显著少于对照组患者(P<0.05);出院时,观察组患者的HR、MVV、FEV1显著优于对照组患者(P<0.05);观察组患者1年、2年、3年无瘤生存率均高于对照组,但是两组之间的差异无统计学意义(P>0.05)。结论:胸腔镜下肺癌根治术治疗老年非小细胞肺癌,相比传统的开胸手术方法,具有手术时间短、术中出血量和术后引流量少、心肺功能保留情况更好的临床优势。
Objective: To analyze the effect of radical surgery with thoracoscopy in the treatment of senile non-small cell lung cancer( NSCLC) compared with thoracotomy. Methods: From May 2013 to December 2016,120 elderly patients with NSCLC were divided into the observation group with lung cancer radical surgery under the thoracoscopy and the control group with thoracotomy,60 cases in each group. Comparison of indicators in both surgeries in two groups were made including operation time,heart rate( HR),intraoperative volume of bleeding and postoperative volume of drainage,the cardiopulmonary function index before treatment and when discharged from hospital including the maximum vacation value( MVV),forced expiratory volume in one second( FEV1),and the statistical difference of disease-free survival rate( three years' follow-up after discharge). Results: The operation time for the observation group was significantly shorter than that for the control group( P < 0. 05),and the intraoperative volume of bleeding and postoperative volume of drainage,were significantly less than those in the control group( P < 0. 05. When discharged,HR,MVV,FEV1 in the observation group were significantly better than those in the control group( P < 0. 05). The survival rate in the observation group was higher than that in the control group in the 1 st,2 ndand 3 rdyears after treatment,but there was no statistical difference between the two groups( P < 0. 05). Conclusion: The treatment of NSCLC under the thoracoscope is superior to the conventional thoracotomy with shorter operation time,less intraoperative volume of bleeding and less postoperative volume of drainage,and better cardiopulmonary functions.

关键词(KeyWords)： 胸腔镜;胸外科手术;癌,非小细胞肺;老年人;远期生存率
thoracoscope;thoracotomy;non-small cell lung cancer;elderly;Long-term survival rate

Abstract:

Keywords:

基金项目(Foundation): 宜昌市科学研究与开发项目医疗卫生项目[宜科发(2013)23号A13301-5]

作者(Author): 刘泉,林春娥,夏道奎
LIU Quan,LIN Chun'e,XIA Daokui

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