全腔鏡下肺葉切除術與開胸肺葉切除術治療非小細胞肺癌比較的臨床分析

[摘要] 目的 比較全腔鏡下肺葉切除術與開胸肺葉切除術治療非小細胞肺癌的臨床治療效果。方法 整群選取該院2011年5月—2014年5月收治的116例非小細胞肺癌患者，按照就診時間的單雙號，將其分為對照組和觀察組，每組58例，對對照組行開胸肺葉切除術治療，對觀察組患者行全腔鏡下肺葉切除術治療，對比兩組患者的術后臨床指標以及1年后的生存率與復發率。 結果 對照組的術后鎮痛時間為（5.4±1.3）d、術后住院時間時間為（13.5±5.6）d、術后胸腔引流量為（403.4±87.4）mL、術中出血量為（160.3±39.2）mL、切口長度為（21.6±5.5）cm；觀察組的術后鎮痛時間為（3.5±1.2）d、術后住院時間時間為（7.0±2.1）d、術后胸腔引流量為（231.2±44.3）mL、術中出血量為（96.3±31.3）mL、切口長度為（4.7±2.4）cm。觀察組患者的術后臨床指標優于對照組，差異具有統計學意義（P<0.05），但是手術時間和淋巴結數目的差異無統計學意義（P>0.05）。對照組達到了6.9%的1年復發率、100.0%的1年生存率，觀察組達到了8.6%的1年復發率、100.0%的1年生存率，觀察組患者1年后的生存率和復發率與對照組的差異無統計學意義（P>0.05）。結論 全腔鏡下肺葉切除術療效好，且有利于促進患者恢復、減輕術后疼痛，減少手術創傷，是一種值得臨床推廣的非小細胞肺癌治療方式。

[關鍵詞] 非小細胞肺癌；開胸肺葉切除術；全腔鏡下肺葉切除術

[中圖分類號] R73 [文獻標識碼] A [文章編號] 1674-0742（2016）11（c）-0074-03

[Abstract] Objective Clinical comparison of therapeutic effects of endoscopic lobectomy and thoracotomy lobectomy for non-small cell lung cancer. Methods Group select our hospital May 2011 to May 2014 from 116 cases of non small cell lung cancer patients， According to the single visit time，divided for the observation group and the control group， in the control group underwent thoracotomy with lobectomy in the treatment， the observation group patients for thoracoscopic lobectomy in the treatment of patients with， compared two groups of patients with postoperative temporary bed index and after 1 year survival rate and recurrence rate. Results Control group the postoperative pain time for （5.4 ± 1.3）d， postoperative hospitalization time for （13.5±5.6）d， postoperative chest drainage for （40.34± 87.4）mL， intraoperative bleeding was （160.3±39.2）mL， the length of incision for （21.6±5.5）cm； in the observation group， the postoperative pain time for （3.5±1.2）d， postoperative hospitalization time for（7.0±2.1）d， postoperative chest drainage for（23.12±44.3）mL， intraoperative bleeding was （96.3±31.3）mL， the length of incision for（4.7± 2.4）cm. Compared with the control group， the clinical indexes of the observation group were better than the control group， the difference was statistically significant （P < 0.05）， but there was no significant difference between the operation time and the number of lymph nodes （P > 0.05）. Control group reached 6.9% 1-year recurrence rate and 100.0% of the 1 year survival rate， the observation group reached 8.6% 1-year recurrence rate， 100.0% of the 1 year survival rate observed groups of patients after 1 year survival rate and recurrence rate and control group differences had no statistical significance （P > 0.05）. Conclusion Thoracoscopic lobectomy are conducive to promoting the recovery of patients， reduce postoperative pain， reduce the surgical trauma is a worthy of clinical promotion of non small cell lung cancer treatment.

[Key words] Non small cell lung cancer；Pulmonary lobectomy；Total laparoscopic lobectomy

作為一種具有較高的發病率和死亡率的惡性腫瘤，肺癌對人們的生命安全造成了嚴重的威脅。在肺癌中，比較常見的類型是非小細胞肺癌[1]。常見的治療方式是開胸肺葉切除術，但是開胸肺葉切除術具有較大的創傷和術后疼痛。……