浙江医学
浙江醫學
절강의학
ZHEJIANG MEDICAL JOURNAL
2014年
3期
215-217
,共3页
I期非小细胞肺癌%高龄患者%胸腔镜亚叶切除
I期非小細胞肺癌%高齡患者%胸腔鏡亞葉切除
I기비소세포폐암%고령환자%흉강경아협절제
Stage I Non- smal lung cancer%Elderly patients%Video- assisted thoracoscopicsublobar resection
目的探讨胸腔镜肺亚叶切除术治疗I期高龄非小细胞肺癌患者的临床疗效。方法将行手术治疗且术后病理为I期非小细胞肺癌的126例年龄＞70岁的患者分为胸腔镜肺亚叶切除术组（59例）和胸腔镜肺叶切除术组（67例），分析比较两组患者的年龄分布情况、术后并发症、术后引流时间、住院天数及术后随访情况。结果＞75岁患者多选择胸腔镜肺亚叶切除术。胸腔镜肺叶切除术患者总体并发症发生率（40.7%）显著高于胸腔镜肺亚叶切除术患者（19.4%），差异有统计学意义（P=0.047）。胸腔镜肺亚叶切除术患者的平均术后引流时间、住院天数[（3.3±1.0）d、（8.5±1.5）d]短于胸腔镜肺叶切除术患者[（4.4±2.0）d、（12.8±2.0）d]，差异均有统计学意义（均P＜0.01）。两组患者2、3年生存率的差异均无统计学意义（均P＞0.05）。结论胸腔镜肺亚叶切除术治疗老年I期非小细胞肺癌安全性良好，预后与肺叶切除术相似，可以作为老年I期非小细胞肺癌患者尤其是不能耐受肺叶切除者一个较好的选择。
目的探討胸腔鏡肺亞葉切除術治療I期高齡非小細胞肺癌患者的臨床療效。方法將行手術治療且術後病理為I期非小細胞肺癌的126例年齡＞70歲的患者分為胸腔鏡肺亞葉切除術組（59例）和胸腔鏡肺葉切除術組（67例），分析比較兩組患者的年齡分佈情況、術後併髮癥、術後引流時間、住院天數及術後隨訪情況。結果＞75歲患者多選擇胸腔鏡肺亞葉切除術。胸腔鏡肺葉切除術患者總體併髮癥髮生率（40.7%）顯著高于胸腔鏡肺亞葉切除術患者（19.4%），差異有統計學意義（P=0.047）。胸腔鏡肺亞葉切除術患者的平均術後引流時間、住院天數[（3.3±1.0）d、（8.5±1.5）d]短于胸腔鏡肺葉切除術患者[（4.4±2.0）d、（12.8±2.0）d]，差異均有統計學意義（均P＜0.01）。兩組患者2、3年生存率的差異均無統計學意義（均P＞0.05）。結論胸腔鏡肺亞葉切除術治療老年I期非小細胞肺癌安全性良好，預後與肺葉切除術相似，可以作為老年I期非小細胞肺癌患者尤其是不能耐受肺葉切除者一箇較好的選擇。
목적탐토흉강경폐아협절제술치료I기고령비소세포폐암환자적림상료효。방법장행수술치료차술후병리위I기비소세포폐암적126례년령＞70세적환자분위흉강경폐아협절제술조（59례）화흉강경폐협절제술조（67례），분석비교량조환자적년령분포정황、술후병발증、술후인류시간、주원천수급술후수방정황。결과＞75세환자다선택흉강경폐아협절제술。흉강경폐협절제술환자총체병발증발생솔（40.7%）현저고우흉강경폐아협절제술환자（19.4%），차이유통계학의의（P=0.047）。흉강경폐아협절제술환자적평균술후인류시간、주원천수[（3.3±1.0）d、（8.5±1.5）d]단우흉강경폐협절제술환자[（4.4±2.0）d、（12.8±2.0）d]，차이균유통계학의의（균P＜0.01）。량조환자2、3년생존솔적차이균무통계학의의（균P＞0.05）。결론흉강경폐아협절제술치료노년I기비소세포폐암안전성량호，예후여폐협절제술상사，가이작위노년I기비소세포폐암환자우기시불능내수폐협절제자일개교호적선택。
Objective To evaluate the efficacy of thoracoscopic sublobar resection in elderly patients with stage I non- smal celllung cancer (NSCLC). Methods One hundred and twenty six patients with stage I NSCLC aged>70y underwent thoracoscopic resection in our hospital between October 2008 and October 2011, including 67 cases with thoracoscopic sublo-bar resection (study group), and 59 cases with thoracoscopic lobectomy (control group). The age distribution, postoperative complications, chest tube maintenance time, length of hospital stay and the fol ow- up data were retrospectively reviewed and compared between two groups. Results Patients aged>75y were more likely to choose sublobar resection. The total compli-cation rate in control group was significantly higher than that in study group (40.7%vs 19.4%, P=0.047). The chest tube mainte-nance time and length of hospital stay was longer in control group than in those study group (4.4±2.0d vs 3.3±1.0d, and 12.8± 2.0d vs 8.5±1.5d, respectively;both P<0.01). There was no significant difference in estimated 2- and 3- year survival rate be-tween two groups (P>0.05). Conclusion Thoracoscopic sublobar resection can be performed safely in elderly patients with stage I NSCLC and the clinical efficacy is comparable with the thoracoscopic lobectomy.
