中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2010年
17期
1285-1288
,共4页
张轶%姜格宁%王群%朱余明%丁嘉安%陈昶%陈晓峰%汪浩%谢博雄%李文涛%童稳圃
張軼%薑格寧%王群%硃餘明%丁嘉安%陳昶%陳曉峰%汪浩%謝博雄%李文濤%童穩圃
장질%강격저%왕군%주여명%정가안%진창%진효봉%왕호%사박웅%리문도%동은포
癌,非小细胞肺%胸腔镜检查%肺切除术%白细胞介素类
癌,非小細胞肺%胸腔鏡檢查%肺切除術%白細胞介素類
암,비소세포폐%흉강경검사%폐절제술%백세포개소류
Carcinoma,non-small-cell lung%Thoracoscopy%Pneumonectomy%Interleukins
目的 比较电视胸腔镜手术(VATS)与开胸手术(OT)肺叶切除术治疗早期非小细胞肺癌(NSCLC)中急性炎症反应和免疫抑制的差异.方法 前瞻性随机对照研究.按照入组标准筛选病例,随机分组后手术,收集临床资料,并检测手术前后IL-6、IL-8和IL-10的血浆浓度.2007年1月至2008年6月最终入选病例271例,其中VATS组133例,OT组138例;男性132例,女性139例;年龄19～70岁,平均(56±8)岁.结果 在术后住院时间[(8.2±2.5)d比(9.8±6.2)d,P=0.03]和术后并发症发生率(11.3%比21.7%,P=0.02)上,VATS组优于OT组.VATS组患者的IL-6血浆浓度在术后第1天[(35±25)%比(65±43)%,P=0.00]、术后第3天[(14±22)%比(55±44)%,P=0.00]以及IL-10血浆浓度在术后第1天的升幅[(25±20)%比(43±35)%,P=0.00]低于OT组.结论 相比于OT,VATS治疗早期NSCLC具有术后炎症反应轻、免疫抑制弱的特点.
目的 比較電視胸腔鏡手術(VATS)與開胸手術(OT)肺葉切除術治療早期非小細胞肺癌(NSCLC)中急性炎癥反應和免疫抑製的差異.方法 前瞻性隨機對照研究.按照入組標準篩選病例,隨機分組後手術,收集臨床資料,併檢測手術前後IL-6、IL-8和IL-10的血漿濃度.2007年1月至2008年6月最終入選病例271例,其中VATS組133例,OT組138例;男性132例,女性139例;年齡19～70歲,平均(56±8)歲.結果 在術後住院時間[(8.2±2.5)d比(9.8±6.2)d,P=0.03]和術後併髮癥髮生率(11.3%比21.7%,P=0.02)上,VATS組優于OT組.VATS組患者的IL-6血漿濃度在術後第1天[(35±25)%比(65±43)%,P=0.00]、術後第3天[(14±22)%比(55±44)%,P=0.00]以及IL-10血漿濃度在術後第1天的升幅[(25±20)%比(43±35)%,P=0.00]低于OT組.結論 相比于OT,VATS治療早期NSCLC具有術後炎癥反應輕、免疫抑製弱的特點.
목적 비교전시흉강경수술(VATS)여개흉수술(OT)폐협절제술치료조기비소세포폐암(NSCLC)중급성염증반응화면역억제적차이.방법 전첨성수궤대조연구.안조입조표준사선병례,수궤분조후수술,수집림상자료,병검측수술전후IL-6、IL-8화IL-10적혈장농도.2007년1월지2008년6월최종입선병례271례,기중VATS조133례,OT조138례;남성132례,녀성139례;년령19～70세,평균(56±8)세.결과 재술후주원시간[(8.2±2.5)d비(9.8±6.2)d,P=0.03]화술후병발증발생솔(11.3%비21.7%,P=0.02)상,VATS조우우OT조.VATS조환자적IL-6혈장농도재술후제1천[(35±25)%비(65±43)%,P=0.00]、술후제3천[(14±22)%비(55±44)%,P=0.00]이급IL-10혈장농도재술후제1천적승폭[(25±20)%비(43±35)%,P=0.00]저우OT조.결론 상비우OT,VATS치료조기NSCLC구유술후염증반응경、면역억제약적특점.
Objective To compare video-assisted thoracic surgery (VATS) and open thoracotomy (OT) on acute inflammatory responses and immunosuppression after lobectomy for early non-small cell lung cancer (NSCLC). Methods Present prospective randomized study. OT or VATS lobectomy was performed in patients who met enter criteria and clinical data was collected. Plasma concentration of IL-6, IL-8 and IL10 were measured before surgery and at postoperative day (POD) 1 and POD 3. There were 271 patients underwent lobectomy for early NSCLC, including of 133 patients in group VATS and 138 patients in group OT from January 2007 to June 2008. There were 132 males and 139 females, aging from 19 ～70 years with a mean of ( 56 ± 8) years. Results Compared with OT group, shorter postoperative hospital stay [ ( 8.2 ±2.5) dvs. (9.8±6.2) d, P=0.03], lower morbidity rate (11.3% vs. 21.7%, P=0.02) and lower increase of plasma concentration of IL-6 at POD 1 [ ( 35 ± 25 ) % vs. (65 ± 43 ) %, P = 0.00 ], IL-6 at POD 3 [(14±22)% vs. (55±44)%,P=0.00] and IL-10 at POD 1 [(25 ±20)% vs. (43±35)%, P=0.00] were observed in patients of VATS group. Conclusion VATS lobectomy for early NSCLC is associated with less acute inflammatory responses and less immunosuppression when compared with OT.
