中国社区医师
中國社區醫師
중국사구의사
Chinese Community Doctors
2015年
6期
32-33
,共2页
全胸腔镜肺叶切除术%肺癌%早期
全胸腔鏡肺葉切除術%肺癌%早期
전흉강경폐협절제술%폐암%조기
Thoracoscopic lobectomy%Lung cancer%Early
目的：探讨全胸腔镜肺叶切除治疗早期肺癌的临床疗效。方法：2013年5月-2014年9月收治早期肺癌患者80例，随机分成观察组和对照组，各40例，所有患者均行常规术前准备和护理，对照组采取传统的开胸肺叶切除术，麻醉方法采取全身麻醉双腔气管插管，术中单肺通气，切断第6肋后于第5肋间进胸，常规清扫纵膈及肺门淋巴结，若患者病变发生在右肺，则清扫第2、4及7～9组淋巴结，若患者病变发生在左肺，要清扫第5～9组淋巴结。观察组行全胸腔镜肺叶切除术，于第7肋间切口置入胸腔镜，麻醉方法及淋巴结的清扫措施与对照组相同。结果：观察组手术时间(121.2±15.1)min，术中出血量(198.2±32.5)mL，术后疼痛水平(72.6±3.9)，术后住院时间(5.1±0.4)d，发生并发症1例，并发症发生率2.5%。对照组手术时间(141.2±22.8)min，术中出血量(285.6±44.2)mL，术后疼痛水平(81.5±6.1)，术后住院时间(6.8±0.6)d，发生并发症8例，并发症发生率20.0%。两组比较差异有统计学意义(P＜0.05)。结论：全胸腔镜肺叶切除治疗早期肺癌术中出血少，患者痛苦小，恢复快，值得临床推广。
目的：探討全胸腔鏡肺葉切除治療早期肺癌的臨床療效。方法：2013年5月-2014年9月收治早期肺癌患者80例，隨機分成觀察組和對照組，各40例，所有患者均行常規術前準備和護理，對照組採取傳統的開胸肺葉切除術，痳醉方法採取全身痳醉雙腔氣管插管，術中單肺通氣，切斷第6肋後于第5肋間進胸，常規清掃縱膈及肺門淋巴結，若患者病變髮生在右肺，則清掃第2、4及7～9組淋巴結，若患者病變髮生在左肺，要清掃第5～9組淋巴結。觀察組行全胸腔鏡肺葉切除術，于第7肋間切口置入胸腔鏡，痳醉方法及淋巴結的清掃措施與對照組相同。結果：觀察組手術時間(121.2±15.1)min，術中齣血量(198.2±32.5)mL，術後疼痛水平(72.6±3.9)，術後住院時間(5.1±0.4)d，髮生併髮癥1例，併髮癥髮生率2.5%。對照組手術時間(141.2±22.8)min，術中齣血量(285.6±44.2)mL，術後疼痛水平(81.5±6.1)，術後住院時間(6.8±0.6)d，髮生併髮癥8例，併髮癥髮生率20.0%。兩組比較差異有統計學意義(P＜0.05)。結論：全胸腔鏡肺葉切除治療早期肺癌術中齣血少，患者痛苦小，恢複快，值得臨床推廣。
목적：탐토전흉강경폐협절제치료조기폐암적림상료효。방법：2013년5월-2014년9월수치조기폐암환자80례，수궤분성관찰조화대조조，각40례，소유환자균행상규술전준비화호리，대조조채취전통적개흉폐협절제술，마취방법채취전신마취쌍강기관삽관，술중단폐통기，절단제6륵후우제5륵간진흉，상규청소종격급폐문림파결，약환자병변발생재우폐，칙청소제2、4급7～9조림파결，약환자병변발생재좌폐，요청소제5～9조림파결。관찰조행전흉강경폐협절제술，우제7륵간절구치입흉강경，마취방법급림파결적청소조시여대조조상동。결과：관찰조수술시간(121.2±15.1)min，술중출혈량(198.2±32.5)mL，술후동통수평(72.6±3.9)，술후주원시간(5.1±0.4)d，발생병발증1례，병발증발생솔2.5%。대조조수술시간(141.2±22.8)min，술중출혈량(285.6±44.2)mL，술후동통수평(81.5±6.1)，술후주원시간(6.8±0.6)d，발생병발증8례，병발증발생솔20.0%。량조비교차이유통계학의의(P＜0.05)。결론：전흉강경폐협절제치료조기폐암술중출혈소，환자통고소，회복쾌，치득림상추엄。
Objective:To investigate the clinical curative effect of complete video-assisted thoracoscopic lobectomy in the treatment of early lung cancer.Methods:80 patients with early stage lung cancer were selected from May 2013 to September 2014. They were randomly divided into the observation group and the control group with 40 cases in each.All of the patients were given the routine preoperative preparation and nursing care,while the control group adopted the traditional thoracotomy lobectomy. Anesthesia method adopts the general anesthesia double lumen endotracheal intubation,single pulmonary ventilation during the operation,we cuted the sixth rib from the fifth intercostal into chest.We cleaned the mediastinal and hilar lymph node regularly.If the patients lesions in the right lung,we cleaned up the second, fouth and seventh to ninth groups of lymph nodes.If the patients’ lesions occurred in the left lung,we cleaned up the fifth to ninth group lymph nodes.The observation group underwent thoracoscopic lobectomy,from the seventh intercostal incision implantation thoracoscopy,the anesthesia measures and the lymph node sweeping methods were same as the control group.Results:The operation time of the observation group was(121.2±15.1) min;the amount of bleeding during operation was(198.2 ± 32.5) mL;the level of pain after operation was(72.6 ± 3.9);the time of hospitalization after operation was(5.1±0.4) d;1 case occurred complications,and the complication rate was 2.5%.The operation time of the control group was(141.2±22.8) min;the amount of bleeding during operation was(285.6±44.2) mL;the level of pain after operation was(81.5±6.1);the time of hospitalization after operation was(6.8±0.6) d;8 patients occurred complications after operation,and the complication rate was 20% .The two groups had statistical significance(P<0.05).Conclusion:Totally thoracoscopic lobectomy in the treatment of early stage lung cancer has less bleeding during the operation,little pain,quick recovery,so it is worth the clinical promotion.
