CAJ | 학술논문

目的：探讨全胸腔镜( c-VATS)和胸腔镜辅助小切口( VAMT)手术治疗肺癌的临床疗效和安全性。方法选择我院采用c-VATS和VAMT手术治疗肺癌患者51例,记录患者手术时间、术中出血量、清扫淋巴结数,术后住院时间、引流管留置时间以及并发症,采用视觉模拟评分法( VAS法)评估患者术后第1 d疼痛程度,分别在术前1 d以及术后1 d、3 d和5 d取静脉血检测血清C反应蛋白( CRP)水平；术后随访1年观察患者复发和转移情况。结果 c-VATS组患者手术时间、术中出血量、清扫淋巴结数以及置管时间均少于VAMT组患者但无统计学差异(P>0.05),c-VATS组患者住院时间和术后第1 d 疼痛评分显著低于VAMT组(P<0.05)。 c-VATS组患者术后1 d、3 d和5 d血清中CRP水平显著低于VAMT组(P<0.05)。 c-VATS组和VAMT组患者并发症发病率分别为7.41%和20.83%,两组患者并发症发病率间无统计学差异( P >0.05)。术后1年 c-VATS 组和 VAMT 组患者复发率分别为3.70%和4.17%,转移率分别为7.41%和12.50%,两组患者术后1年复发率和转移率间无统计学差异( P>0.05)。结论 c-VATS和VAMT手术治疗肺癌均具有较好的临床疗效,但c-VATS安全性优于VAMT手术。
목적：탐토전흉강경( c-VATS)화흉강경보조소절구( VAMT)수술치료폐암적림상료효화안전성。방법선택아원채용c-VATS화VAMT수술치료폐암환자51례,기록환자수술시간、술중출혈량、청소림파결수,술후주원시간、인류관류치시간이급병발증,채용시각모의평분법( VAS법)평고환자술후제1 d동통정도,분별재술전1 d이급술후1 d、3 d화5 d취정맥혈검측혈청C반응단백( CRP)수평；술후수방1년관찰환자복발화전이정황。결과 c-VATS조환자수술시간、술중출혈량、청소림파결수이급치관시간균소우VAMT조환자단무통계학차이(P>0.05),c-VATS조환자주원시간화술후제1 d 동통평분현저저우VAMT조(P<0.05)。 c-VATS조환자술후1 d、3 d화5 d혈청중CRP수평현저저우VAMT조(P<0.05)。 c-VATS조화VAMT조환자병발증발병솔분별위7.41%화20.83%,량조환자병발증발병솔간무통계학차이( P >0.05)。술후1년 c-VATS 조화 VAMT 조환자복발솔분별위3.70%화4.17%,전이솔분별위7.41%화12.50%,량조환자술후1년복발솔화전이솔간무통계학차이( P>0.05)。결론 c-VATS화VAMT수술치료폐암균구유교호적림상료효,단c-VATS안전성우우VAMT수술。
Objective To explore the clinical efficacy and safety of complete video-assisted thoracoscopic ( c-VATS) and assisted thoracic small incision surgery ( VAMT) in the treatment of lung cancer. Methods 51 lung cancer patients treated with c-VATS and VAMT were chosen in our hospital from August 2009 to October 2012. Their operative time, blood loss, number of lymph node dissection, postoperative hospital stay, drainage tube indwelling time and complications were recorded. The degree of pain at the first day after operation was assessed by a visual ana-log scale ( VAS) , and the level of C-reactive protein ( CRP) in serum was detected. The situation of relapse and me-tastasis was observed one year after operation. Results The operative time, blood loss, number of lymph node dis-section and postoperative hospital stay in the c-VATS group were less than in the VAMT group, but there was no sta-tistical difference (P>0. 05). The postoperative hospital stay and score of pain at the first day in the c-VATS group were significantly lower than those in the VAMT group (P<0. 05). The level of CRP in serum were significantly low-er in the c-VATS group than in the VAMT group (P<0. 05). The incidence of complications was 7. 41% and 20. 83% respectively in the c-VATS group and the VAMT group (P>0. 05). The rate of relapse was 3. 70% and 4. 17%, and the rate of transfer was 7. 41% and 12. 50% respectively in the c-VATS group and the VAMT group (P>0. 05 ) . Conclusion The complete video-assisted thoracoscopic and assisted thoracic small incision surgery has bet-ter clinical efficacy, but the safety of complete video-assisted thoracoscopic is better than assisted thoracic small inci-sion surgery.