胸腔镜肺段和肺叶切除术在早期非小细胞肺癌中的应用效果比较

申振盛

摘  要：目的  对比胸腔镜肺段与肺叶切除术两种方式用于早期非小细胞肺癌治疗的结果和预后情况。方法  本研究选择阳谷县人民医院胸外科2018年1月～2020年1月间收治100例早期非小细胞肺癌患者为观察对象，利用回顾性分析法，从患者不同的手术治疗方案出发将其分为对照组（50例，肺叶切除术治疗）和实验组（50例，胸腔镜肺段切除术治疗），对患者的整体治疗结果和预后情况进行对比分析。结果  在手术治疗的出血量、术后引流量方面，实验组均少于对照组，而在手术时间、引流管留置时间、住院时间方面，实验组也短于对照组（P<0.05）。两组淋巴结清除数量对比差异较小（P>0.05）。实验组并发症发生率显著低于对照组，两组差异明显（P<0.05）。结论  与肺叶切除手术相比，胸腔镜肺段切除术用于早期非小细胞肺癌的治疗，操作方法更加简单，患者术后恢复速度更快，且手术出血量较少，术后并发症发生率更低，因而整体治疗效果更加理想，应用价值更高。

关键词：胸腔镜肺段切除术;肺叶切除术;早期非小细胞肺癌;临床效果;并发症

中图分类号：R734.2    文献标识码：A    文章编号：1009-8011（2021）-5-0010-03

Abstract： Objective  To compare the outcome and prognosis of thoracoscopic segmentectomy and lobectomy in the treatment of early stage non-small cell lung cancer. Methods  In this study， 100 cases of patients with early non-small cell lung cancer in our hospital from January 2018 to January 2020 were selected as the observation objects The patients were divided into control group（50 cases， lobectomy treatment） and experimental group（50 cases， thoracoscopic segmentectomy treatment）. The overall treatment results and prognosis of patients were compared and analyzed. Results  the bleeding volume and postoperative drainage volume of the experimental group were less than those of the control group， while the operation time， drainage tube indwelling time and hospitalization time in the experimental group were also shorter than those in the control group（P<0.05）. There was little difference in the number of lymph node clearance between the two groups（P>0.05）. The incidence of complications in the experimental group was significantly lower than that in the control group（P<0.05）. Conclusion  Compared with lobectomy， thoracoscopic segmentectomy for the treatment of early non-small cell lung cancer，the operation method is more simple， the postoperative recovery speed of patients is faster， and the amount of bleeding is less， the incidence of postoperative complications is lower， so the overall treatment effect is more ideal， and the application value is higher.

Keywords： thoracoscopic segmentectomy; lobectomy; early non-small cell lung cancer; clinical effect; complications

肺癌是一種临床常见的恶性肿瘤疾病，该疾病患者的死亡率相对较高，当前临床上对于肺癌的发生机制尚未完全明确，但通常认为与职业暴露、环境污染、长期吸烟等因素有关，非小细胞肺癌约占肺癌患者总数的80%以上，其癌细胞生长分裂速度与小细胞肺癌患者相比也相对较慢[1]。患者发病后常会出现咳嗽、咳痰、痰中带血、胸部胀痛等临床表现，因而需要实施早期针对性的临床治疗，以改善患者预后，避免患者出现循环和呼吸系统等恶性后果，降低癌细胞转移风险，延长患者的生存时间。随着微创手术技术的发展完善，也提高了胸腔镜下肺段解剖性切除治疗的有效性和安全性，具有较为理想的治疗效果。……