CAJ | 학술논문

背景与目的传统的肺癌根治手术创伤大，胸腔镜下手术能减少手术创伤，有望改善肺癌患者术后生命质量（quality of life, QOL）。本研究旨在探讨胸腔镜下肺癌根治术对患者QOL的影响。方法使用由欧洲癌症研究与治疗组织（European Organization for Research and Treatment, EORTC）开发的质量核心问卷量表（Quality of Life-Core 30 Questionnaire, QLQ-C30）和针对肺癌患者的补充量表（Quality of Life-Lung Cancer 13 Questionnaire, QLQ-LC13）对60例分别接受胸腔镜和常规开胸肺癌根治术的非小细胞肺癌（non-small cell lung cancer, NSCLC）患者从术前3天至术后24周内的QOL进行评价。结果60例患者一共收回问卷215份，其余25份失访。所有患者的QOL在术后3天时均出现明显下降，常规开胸组和胸腔镜组术前、后3天的总体QOL平均得分分别为：87.8±10.3 vs 38.3±13.1（P<0.001）和82.7±9.6 vs 56.3±14.8（P<0.001）。随后，所有患者的QOL开始回升。常规开胸组患者的QOL下降更为明显，术后3天的总体QOL得分明显低于胸腔镜组（P=0.012,9），术后24周时仍然不能恢复至术前水平（P=0.0124）。胸腔镜组术后QOL下降相对较小，术后24周时大部分指标恢复至术前水平。结论胸腔镜下肺癌根治术创伤小，恢复快，术后QOL高于传统开胸手术，是一种较为可取的肺癌术式。
배경여목적전통적폐암근치수술창상대，흉강경하수술능감소수술창상，유망개선폐암환자술후생명질량（quality of life, QOL）。본연구지재탐토흉강경하폐암근치술대환자QOL적영향。방법사용유구주암증연구여치료조직（European Organization for Research and Treatment, EORTC）개발적질량핵심문권량표（Quality of Life-Core 30 Questionnaire, QLQ-C30）화침대폐암환자적보충량표（Quality of Life-Lung Cancer 13 Questionnaire, QLQ-LC13）대60례분별접수흉강경화상규개흉폐암근치술적비소세포폐암（non-small cell lung cancer, NSCLC）환자종술전3천지술후24주내적QOL진행평개。결과60례환자일공수회문권215빈，기여25빈실방。소유환자적QOL재술후3천시균출현명현하강，상규개흉조화흉강경조술전、후3천적총체QOL평균득분분별위：87.8±10.3 vs 38.3±13.1（P<0.001）화82.7±9.6 vs 56.3±14.8（P<0.001）。수후，소유환자적QOL개시회승。상규개흉조환자적QOL하강경위명현，술후3천적총체QOL득분명현저우흉강경조（P=0.012,9），술후24주시잉연불능회복지술전수평（P=0.0124）。흉강경조술후QOL하강상대교소，술후24주시대부분지표회복지술전수평。결론흉강경하폐암근치술창상소，회복쾌，술후QOL고우전통개흉수술，시일충교위가취적폐암술식。
Background and objective Conventional radical surgeries for lung cancer incur a large amount of trauma, thoracoscopic surgeries can reduce trauma, and hopefully improve patients’ postoperative quality of life (QOL). hTe aim of this study is to evaluate the impact of thoracoscopic radical surgeries on quality of life of patients with non-small cell lung cancer (NSCLC). Methods Use Quality of Life-Core 30 Questionnaire (QLQ-C30) which was exploited by European Organization for Research and Treatment (EORTC) and Quality of Life-Lung Cancer 13 Questionnaire (QLQ-LC13) which is the supplementary questionnaire according to the lung cancer patients to evaluate QOL of 60 NSCLC patients in thoraco-scopic surgery group and conventional surgery group from 3 days before operation to 24 weeks atfer operation. Results A total of 215 questionnaires were collected from 60 patients;25 postoperative questionnaires were not completed because patients could not be contacted for follow-up visits. QOL declined markedly in all patients at 3 days postoperatively;preoperative and 3-day postoperative global QOL scores in the conventional surgery and thoracoscopic surgery group were 87.8±10.3 vs 38.3± 13.1 (P<0.001) and 82.7±9.6 vs 56.3±14.8 (P<0.001), respectively. hTereatfer, QOL recovered gradually in all patients. Patients who underwent open surgery showed the most pronounced decline in QOL;global scores were lower in this group than in the thoracoscopic surgery group (P=0.012,9) at 3 days postoperatively and was not restored to the preoperative level at 24 weeks postoperatively (P=0.012,4). QOL declined less in patients undergoing thoracoscopic surgery, and most indices had recov-ered to preoperative levels at 24 weeks postoperatively. Conclusion With the advantages of small trauma, faster recovery and higher postoperative QOL, thoracoscopic surgery is a preferable lung cancer surgery.