单操作孔胸腔镜下肺癌根治术治疗原发性肺癌的效果研究

周嚷 张文 郑远明

[摘要]目的分析單操作孔胸腔镜下肺癌根治术治疗原发性肺癌的临床效果。方法从桂平市人民医院2019年2月至2021年2月收治的原发性肺癌患者中，前瞻性选取符合研究纳入标准的60例患者作为研究对象，采用抛掷硬币法将其随机分为 A 组（硬币正面，n=30）与 B 组（硬币反面， n=30），在征得患者及其家属同意下，A 组给予传统三孔胸腔镜肺癌根治术治疗，B 组给予单操作孔胸腔镜肺癌根治术治疗，收集和比较两组围术期临床数据、视觉模拟疼痛（VAS）评分、术后并发症发生率。结果两组手术时间、术中出血量、引流量、引流管留置时间、淋巴结清扫数目比较 ， 差异无统计学意义（ P >0.05），B 组住院时间短于 A 组，差异有统计学意义（ P <0.05）。术后第1、3天， B 组 VAS 评分、C 反应蛋白（CRP）水平低于 A 组，差异具有统计学意义（ P <0.05）。两组术后并发症发生率比较，差异无统计学意义（ P >0.05）。结论采用单操作孔胸腔镜下肺癌根治术治疗原发性肺癌的疗效较理想，可显著减轻患者的术后疼痛，促进其快速恢复。 [关键词]单操作胸腔镜下孔肺癌根治术;三孔胸腔镜肺癌根治术;原发性肺癌;淋巴结清扫数目; C 反应蛋白

[中图分类号] R734.2 [文献标识码] A  [文章编号]2095-0616（2021）22-0177-04

Study on clinical effect of single-port thoracoscopic radical resection in the treatment of primary lung cancer

ZHOU  Rang   ZHANG  Wen   ZHENG  Yuanming

Department of Cardiothoracic Surgery， Guiping People's Hospital， Guangxi， Guiping 537200， China

[Abstract] Objective To analyze the clinical effect of single-port thoracoscopic radical resection in the treatment of primary lung cancer （PLC）. Methods A total of 60 patients who met the inclusion criteria of the study were prospectively selected from PLC patients treated in Guiping People's Hospital from February 2019 to February 2021. They were randomly divided into group A （n=30， on the front of coin） and gr91oup B （n=30， on the back of coin） by coin toss method. With the consent of patients and their families， group A was given traditional three-port thoracoscopic radical resection for lung cancer， while group B was given single-port thoracoscopic radical resection for lung cancer. The perioperative clinical data ，VAS score and the incidence of postoperative complications of the two groups were collected and compared. Results There were no significant differences in operation time， intraoperative blood loss， drainage volume， indwelling time of drainage tube and the number of lymph node dissected between the two groups （P >0.05）， but the hospitalization time in group B was shorter than that in group A， with statistically significant differences （P <0.05）. On the 1st and 3rd day after operation， the score of Visual Analogue Scale （VAS） and the level of C-reactive protein （CRP） in group B were lower than those in group A， with statistically significant differences （P <0.05）. There was no significant difference in the incidence of postoperative complications between the two groups （P >0.05）. Conclusion The single-port thoracoscopic radical resection is effective in the treatment of PLC， which can significantly reduce postoperative pain and promote rapid recovery.

[Key words] Single-port thoracoscopic radical resection of lung cancer; Three-port thoracoscopic radical resection of lung cancer; Primary lung cancer; Number of lymph node dissected; C-reactive protein

原發性肺癌主要分为周围型肺癌和中央型肺癌，多数由环境污染、吸烟等因素引起。原发性肺癌主要采用外科手术治疗，早、中期癌症患者采用肺癌根治术可以完全切除癌症原发病灶和转移的淋巴结，实现临床治愈[1]。微创化是近年来外科发展的趋势，以胸腔镜手术为代表的胸部微创手术广泛应用于临床，同时胸腔镜下肺癌根治术逐渐取代大部分常规开胸肺叶切除术[2]。目前……