CAJ | 학술논문

目的比较电视辅助胸腔镜和小切口开胸肺切除术治疗临床早期非小细胞肺癌(NSCLC)在手术损伤以及术后恢复的差异.方法 2004年3月至2006年12月将47例临床早期NSCLC患者随机分为胸腔镜组和小切口组手术.记录手术切口长度、手术时间和术中出血量.测定术前,术后4、24和48 h患者血浆IL-6和IL-10的水平.采用视觉模拟评分法于术前至术后第7天进行疼痛评分.于术前到术后第7天进行Karnofsky功能状态评分.结果胸腔镜组切口长度(6.0±0.9)cm,小切口组(12.5±1.5)cm.手术时间、术中出血量两组差异均无统计学意义.术后第5～7天胸腔镜组疼痛较轻(P＜0.05).术后4、24和48 h血浆IL-6和IL-10的水平两组间差异均无统计学意义.术后第2～7天胸腔镜组Karnofsky功能状态评分较高(P＜0.01).结论胸腔镜肺切除术比小切口手术疼痛轻,恢复快,但细胞因子反应无差异.
목적 비교전시보조흉강경화소절구개흉폐절제술치료림상조기비소세포폐암(NSCLC)재수술손상이급술후회복적차이.방법 2004년3월지2006년12월장47례림상조기NSCLC환자수궤분위흉강경조화소절구조수술.기록수술절구장도、수술시간화술중출혈량.측정술전,술후4、24화48 h환자혈장IL-6화IL-10적수평.채용시각모의평분법우술전지술후제7천진행동통평분.우술전도술후제7천진행Karnofsky공능상태평분.결과 흉강경조절구장도(6.0±0.9)cm,소절구조(12.5±1.5)cm.수술시간、술중출혈량량조차이균무통계학의의.술후제5～7천흉강경조동통교경(P＜0.05).술후4、24화48 h혈장IL-6화IL-10적수평량조간차이균무통계학의의.술후제2～7천흉강경조Karnofsky공능상태평분교고(P＜0.01).결론 흉강경폐절제술비소절구수술동통경,회복쾌,단세포인자반응무차이.
Objective To compare the differences of injuries and recovery between video-assisted thoracoscopic surgery(VATS)and mini-thoracotomy(MT)in patients with clinical early stage non-small cell lung cancer(NSCLC)after lobectomy.Methods From March 2004 to December 2006,47 consecutive patients with early stage NSCLC with a diameter of tumor less than 6 cm were recruited and randomized to VATS group and MT group.Incision length,duration of operation and intraoperative blood loss were recorded.Postoperative pain was assessed using a visual analogue scale before operation and daily for the first 7 days after operation.The serum levels of interleukin-6(IL-6)and interleukin-10(IL-10)were measured by cytometric bead array before operation and at 4,24,and 48 h after operation.Karnofsky performance status(KPS)was assessed before operation and daily for the first 7 days after operation.Results Incision length was(6.0±0.9)cm in the VATS group and(12.5±1.5)cm in the MT group.There was no significant difference in duration of operation and intraoperative blood loss between the VATS group and the MT group.Postoperative pain was significantly less in the VATS group in the 5th to 7th day postoperatively(P＜0.05).There was no significant difference of serum concentrations of IL-6 and IL-10 between the VATS group and the MT group at 4,24,and 48 h after operation.KPS score was significantly higher in the VATS group on 2nd to 7th day postoperatively(P＜0.05).Conclusion Compared with MT,VATS for lobectomy has less postoperative pain,faster recovery,but can't reduce postoperative release of cytokines.