单孔与三孔胸腔镜下肺叶切除术治疗非小细胞肺癌的临床疗效对比分析(1)
[摘要] 目的 研究非小细胞肺癌患者采用单孔与三孔胸腔镜下肺叶切除术的临床效果及作用。方法 方便選择2017年4月—2018年4月该院收治非小细胞肺癌患者82例，采用随机数字表法将其分为实验组与参照组，每组均41例。其中，参照组采用三孔胸腔镜下肺叶切除术治疗模式，实验组实施单孔胸腔镜下肺叶切除术，对比2组患者治疗相关指标、淋巴清扫情况及并发症。 结果 实验组手术时长、出血量、引流时长、引流量、住院时长、VAS评分分别为(187.02±18.54)min、(99.45±12.71)mL、(4.38±0.94)d、(686.40±47.91)mL、(7.42±1.69)d、(1.51±0.68)分，参照组为(171.86±19.82)min、(185.63±16.87)mL、(4.49±1.16)d、(692.66±52.08)mL、(9.36±1.48)d、(4.43±1.20)分，(t=3.576 7、26.125 3、0.471 7、0.566 4、 5.529 6、13.555 7，P=0.000 6、0.000 0、0.638 4、0.572 7、0.000 0、0.000 0)，实验组手术时间长于参照组，与参照组相比，实验组出血量较少、住院时长较短、VAS评分较低，两者差异有统计学意义(P<0.05)，实验组与参照组引流时长与引流量差异无统计学意义(P>0.05)。实验组淋巴结清扫数、站数、N2淋巴结清扫数、站数分别为(20.61±3.51)个、(4.81±0.92)站、(15.53±1.86)个、(3.53±0.97)站，参照组为(21.05±3.62)个、(4.76±1.10)站、(15.43±1.94)个、(3.61±1.03)站，(t=0.558 7、0.223 2、0.238 2、0.362 0，P=0.577 9、0.823 9、0.812 3、0.718 3)，实验组与参照组淋巴结、N2淋巴结的清扫数及站数差异无统计学意义(P>0.05)。实验组肺不张1例、感染3例、肺漏气1例、乳糜胸1例、气肿2例，参照组肺不张2例、感染2例、肺漏气3例、乳糜胸2例、气肿3例，(χ2=0.3460、0.213 0、1.051 3、0.346 0、0.213 0，P=0.556 3、0.644 4、0.305 2、0.556 3、0.644 4)。 结论 与三孔胸腔镜下肺叶切除术相比，单孔模式出血量较低、对患者造成的损伤较小。
[关键词] 单孔胸腔镜;三孔胸腔镜;肺叶切除术;非小细胞肺癌
[中图分类号] R734.2 [文献标识码] A [文章编号] 1674-0742(2019)02(a)-0041-03
[Abstract] Objective To investigate the clinical effects of single- and three-hole thoracoscopic lobectomy in patients with non-small cell lung cancer. Methods From April 2017 to April 2018， 82 patients with non-small cell lung cancer were conveniently enrolled in our hospital. The patients were divided into experimental group and reference group by random number table method， with 41 cases in each group. Among them， the reference group was treated with three-hole thoracoscopic lobectomy， and the experimental group underwent single-hole thoracoscopic lobectomy. The treatment-related indicators， lymphatic dissection and complications were compared between the two groups. Results In the experimental group， the length of operation， the amount of bleeding， the length of drainage， the drainage volume， the length of hospital stay， and the VAS score were (187.02±18.54)min， (99.45±12.71)mL， (4.38±0.94)d， (686.40±47.91)mL， (7.42±1.69)d， (1.51±0.68)points， reference group (171.86±19.82)min， (185.63±16.87)mL， (4.49±1.16)d， (692.66±52.08)mL， (9.36±1.48)d， (4.43 ± 1.20) points(t=3.576 7， 26.125 3， 0.471 7， 0.566 4， 5.529 6， 13.555 7， P=0.000 6， 0.000 0， 0.638 4， 0.572 7， 0.000 0， 0.000 0)， the experimental group surgery time was longer than the reference group， and the reference group compared with the experimental group， the amount of bleeding was small， the length of hospital stay was shorter， and the VAS score was lower. The difference was statistically significant (P<0.05). There was no statistically significant difference between the experimental group and the reference group (P>0.05). In the experimental group， the number of lymph node dissection， the number of stations， the number of N2 lymph node dissections， and the number of stations were (20.61±3.51)， (4.81±0.92)stations， (15.53±1.86)， and (3.53±0.97)stations， respectively， (21.05±3.62)， (4.76±1.10)stations， (15.43±1.94)， (3.61±1.03)stations， (t=0.558 7， 0.223 2， 0.238 2， 0.362 0， P=0.577 9， 0.823 9， 0.812 3， 0.718 3). There was no statistically significant difference in the number of lymph nodes and N2 lymph nodes between the group and the reference group (P>0.05). In the experimental group， there were 1 case of atelectasis， 3 cases of infection， 1 case of lung leak， 1 case of chylothorax， 2 cases of emphysema， 2 cases of atelectasis in reference group， 2 cases of infection， 3 cases of lung leak， and 2 cases of chylothorax， 3 cases of emphysema in the control group(χ2=0.346 0， 0.213 0， 1.051 3， 0.346 0， 0.213 0， P=0.556 3， 0.644 4， 0.305 2， 0.556 3， 0.644 4). Conclusion Compared with three-hole thoracoscopic lobectomy， the single-hole mode has a lower amount of bleeding and less damage to the patient., 百拇医药(许哲源 汪洋 彭浩)
[关键词] 单孔胸腔镜;三孔胸腔镜;肺叶切除术;非小细胞肺癌
[中图分类号] R734.2 [文献标识码] A [文章编号] 1674-0742(2019)02(a)-0041-03
[Abstract] Objective To investigate the clinical effects of single- and three-hole thoracoscopic lobectomy in patients with non-small cell lung cancer. Methods From April 2017 to April 2018， 82 patients with non-small cell lung cancer were conveniently enrolled in our hospital. The patients were divided into experimental group and reference group by random number table method， with 41 cases in each group. Among them， the reference group was treated with three-hole thoracoscopic lobectomy， and the experimental group underwent single-hole thoracoscopic lobectomy. The treatment-related indicators， lymphatic dissection and complications were compared between the two groups. Results In the experimental group， the length of operation， the amount of bleeding， the length of drainage， the drainage volume， the length of hospital stay， and the VAS score were (187.02±18.54)min， (99.45±12.71)mL， (4.38±0.94)d， (686.40±47.91)mL， (7.42±1.69)d， (1.51±0.68)points， reference group (171.86±19.82)min， (185.63±16.87)mL， (4.49±1.16)d， (692.66±52.08)mL， (9.36±1.48)d， (4.43 ± 1.20) points(t=3.576 7， 26.125 3， 0.471 7， 0.566 4， 5.529 6， 13.555 7， P=0.000 6， 0.000 0， 0.638 4， 0.572 7， 0.000 0， 0.000 0)， the experimental group surgery time was longer than the reference group， and the reference group compared with the experimental group， the amount of bleeding was small， the length of hospital stay was shorter， and the VAS score was lower. The difference was statistically significant (P<0.05). There was no statistically significant difference between the experimental group and the reference group (P>0.05). In the experimental group， the number of lymph node dissection， the number of stations， the number of N2 lymph node dissections， and the number of stations were (20.61±3.51)， (4.81±0.92)stations， (15.53±1.86)， and (3.53±0.97)stations， respectively， (21.05±3.62)， (4.76±1.10)stations， (15.43±1.94)， (3.61±1.03)stations， (t=0.558 7， 0.223 2， 0.238 2， 0.362 0， P=0.577 9， 0.823 9， 0.812 3， 0.718 3). There was no statistically significant difference in the number of lymph nodes and N2 lymph nodes between the group and the reference group (P>0.05). In the experimental group， there were 1 case of atelectasis， 3 cases of infection， 1 case of lung leak， 1 case of chylothorax， 2 cases of emphysema， 2 cases of atelectasis in reference group， 2 cases of infection， 3 cases of lung leak， and 2 cases of chylothorax， 3 cases of emphysema in the control group(χ2=0.346 0， 0.213 0， 1.051 3， 0.346 0， 0.213 0， P=0.556 3， 0.644 4， 0.305 2， 0.556 3， 0.644 4). Conclusion Compared with three-hole thoracoscopic lobectomy， the single-hole mode has a lower amount of bleeding and less damage to the patient., 百拇医药(许哲源 汪洋 彭浩)