保健医学研究与实践2024,Vol.21Issue(10) :25-30.DOI:10.11986/j.issn.1673-873X.2024.10.05

单孔胸腔镜肺叶切除术治疗高龄NSCLC患者的近期疗效研究

Short-term efficacy of single-port thoracoscopic lobectomy in elderly patients with NSCLC

刘立红 孟庆军 任明明 宋翔 吴大鹏 蒋苗苗 杨萱
保健医学研究与实践2024,Vol.21Issue(10) :25-30.DOI:10.11986/j.issn.1673-873X.2024.10.05

单孔胸腔镜肺叶切除术治疗高龄NSCLC患者的近期疗效研究

Short-term efficacy of single-port thoracoscopic lobectomy in elderly patients with NSCLC

刘立红 1孟庆军 1任明明 1宋翔 1吴大鹏 2蒋苗苗 3杨萱2
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作者信息

  • 1. 河北省沧州市中心医院胸外科,河北 沧州 061000
  • 2. 河北省河间市中医院胸外科,河北 沧州 062450
  • 3. 承德医学院附属医院胸外科,河北 承德 067000
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摘要

目的 探讨单孔胸腔镜肺叶切除术治疗高龄非小细胞肺癌(NSCLC)患者的近期疗效及对血清鳞状上皮细胞癌抗原(SCC)水平的影响,以期为临床治疗提供参考.方法 选取2020年6月—2023年6月河北省沧州市中心医院收治的186例高龄NSCLC患者为研究对象,采用随机数字表法将患者分为单孔组(接受单孔胸腔镜肺叶切除术治疗,n=62)、两孔组(接受两孔胸腔镜肺叶切除术治疗,n=62)、三孔组(接受三孔胸腔镜肺叶切除术治疗,n=62).比较3组患者围手术期指标、术后疼痛数字评分法(NRS)评分、手术前后肺功能指标[第1秒最大用力呼气容积(FEV1)、用力肺活量(FVC)、最大呼气峰流速(PEF)]、手术前后血清SCC水平以及术后并发症发生情况.结果 单孔组、两孔组、三孔组患者术中出血量依次增加,差异均有统计学意义(P<0.05).单孔组患者术后12、24、48 h的NRS评分均低于两孔组和三孔组,且两孔组低于三孔组,差异均有统计学意义(P<0.05).术前,3组患者FEV1、FVC、PEF比较,差异均无统计学意义(P>0.05).术后4个月时,3组患者FEV1、FVC均大于术前,且单孔组大于两孔组和三孔组,两孔组大于三孔组,差异均有统计学意义(P<0.05);术后4个月时,3组患者PEF快于术前,且单孔组快于两孔组和三孔组,两孔组快于三孔组,差异均有统计学意义(P<0.05).术前,3组患者SCC水平比较,差异无统计学意义(P>0.05).术后7 d,3组患者SCC水平均低于术前,且单孔组低于两孔组和三孔组,两孔组低于三孔组,差异均有统计学意义(P<0.05).单孔组患者术后并发症发生率均低于两孔组、三孔组,差异有统计学意义(P<0.05).结论 与两孔、三孔胸腔镜肺叶切除术相比,单孔胸腔镜肺叶切除术可以更好地减少高龄NSCLC患者术中出血量和术后并发症的发生,减轻术后疼痛,改善肺功能,并降低术后血清SCC水平.

Abstract

Objective To investigate the short-term efficacy of single-port thoracoscopic lobectomy in elderly patients with non-small cell lung cancer(NSCLC)and its impact on the antigen levels of serum squamous cell carcinoma(SCC),aiming to provide a reference for clinical treatment.Methods A total of 186 elderly NSCLC patients admitted to the Cangzhou Cen-tral Hospital from June 2020 to June 2023 were selected as the study participants.Patients were assigned to a single-port group(underwent single-port thoracoscopic lobectomy,n=62),a two-port group(underwent two-port thoracoscopic lobec-tomy,n=62),and a three-port group(underwent three-port thoracoscopic lobectomy,n=62)using a random number ta-ble method.The perioperative indicators,postoperative pain numerical rating scale(NRS)scores,pulmonary function indi-cators[forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),peak expiratory flow(PEF)]before and after surgery,serum SCC levels before and after surgery,and the incidence of postoperative complications were compared a-mong the three groups.Results The intraoperative blood loss in the single-port group,two-port group,and three-port group increased sequentially,with statistically significant differences(P<0.05).The NRS scores at 12,24,and 48 hours postoperatively in the single-port group were lower than those in the two-port and three-port groups,and the two-port group was lower than the three-port group,with statistically significant differences(P<0.05).Before surgery,no significant differences were observed in FEV1,FVC,and PEF among the three groups(P>0.05).At 4 months postoperatively,the FEV1 and FVC in all three groups were increased,and the single-port group was greater than the two-port and three-port groups,with significant differences(P<0.05);the PEF in all three groups was significantly faster than before surgery,and the single-port group was significantly faster than the two-port and three-port groups(P<0.05).Before surgery,no significant differences were noted in SCC levels among the three groups(P>0.05).At 7 days postoperatively,the SCC lev-els in all three groups showed significant decline,and the single-port group was significantly lower than the two-port and three-port groups(P<0.05).The incidence of postoperative complications in the single-port group was significantly lower than that in the two-port and three-port groups(P<0.05).Conclusion Compared with two-port and three-port thoraco-scopic lobectomy,single-port thoracoscopic lobectomy can better reduce intraoperative blood loss and the incidence of post-operative complications in elderly NSCLC patients,alleviate postoperative pain,improve pulmonary function,and lower postoperative serum SCC levels.

关键词

非小细胞肺癌/高龄/单孔胸腔镜肺叶切除术/鳞状上皮细胞癌抗原

Key words

Non-small cell lung cancer/Elderly/Single-port thoracoscopic lobectomy/Squamous cell carcinoma antigen

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出版年

2024
保健医学研究与实践
西南大学

保健医学研究与实践

CSTPCD
影响因子:0.512
ISSN:1673-873X
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