海南医学
海南醫學
해남의학
HAINAN MEDICAL JOURNAL
2015年
3期
351-353,354
,共4页
郑江敏%李栋%郭志刚%高文华
鄭江敏%李棟%郭誌剛%高文華
정강민%리동%곽지강%고문화
胸腔镜%微创%非小细胞肺癌
胸腔鏡%微創%非小細胞肺癌
흉강경%미창%비소세포폐암
Thoracoscopic%Minimally invasive%Non-small cell lung cancer
目的：探讨胸腔镜微创手术治疗Ⅰ/Ⅱ期非小细胞肺癌患者的疗效和安全性。方法82例Ⅰ/Ⅱ期非小细胞肺癌患者采取倾向性评分法进行配对，选出60例患者，根据手术方式分为微创组和开胸组，两组各30例。比较两组围手术期的指标以及随访结果。结果观察组的手术时间、术中出血量及住院时间均明显小于对照组[(150.8±48.6) min vs (181.6±62.9) min，(162.6±138.5) ml vs (247.6±165.0) ml，(9.1±2.2) min vs (10.8±2.9) min， P<0.05]，两组的术中清扫淋巴结的组数与个数、术后引流时间、围手术期的死亡率及术后并发症发生率比较差异均无统计学意义(P>0.05)。微创组的1年、3年局部复发率分别为3.3%、10.0%，而开胸组分别为6.7%、16.7%，两组比较差异均无统计学意义(P=0.704)。微创组的3年、5年远处转移率分别为10.0%、23.3%，而开胸组分别为16.7%、26.7%，两组比较差异均无统计学意义(P=0.766)。微创组的1年、3年生存率分别为90.8%、83.5%，而开胸组分别为75.8%、66.7%，微创组的长期生存率显著高于开胸组(P=0.000)。结论与传统开胸手术相比，胸腔镜微创手术治疗Ⅰ/Ⅱ期非小细胞肺癌的安全性更高，术后恢复快，远期疗效更满意。
目的：探討胸腔鏡微創手術治療Ⅰ/Ⅱ期非小細胞肺癌患者的療效和安全性。方法82例Ⅰ/Ⅱ期非小細胞肺癌患者採取傾嚮性評分法進行配對，選齣60例患者，根據手術方式分為微創組和開胸組，兩組各30例。比較兩組圍手術期的指標以及隨訪結果。結果觀察組的手術時間、術中齣血量及住院時間均明顯小于對照組[(150.8±48.6) min vs (181.6±62.9) min，(162.6±138.5) ml vs (247.6±165.0) ml，(9.1±2.2) min vs (10.8±2.9) min， P<0.05]，兩組的術中清掃淋巴結的組數與箇數、術後引流時間、圍手術期的死亡率及術後併髮癥髮生率比較差異均無統計學意義(P>0.05)。微創組的1年、3年跼部複髮率分彆為3.3%、10.0%，而開胸組分彆為6.7%、16.7%，兩組比較差異均無統計學意義(P=0.704)。微創組的3年、5年遠處轉移率分彆為10.0%、23.3%，而開胸組分彆為16.7%、26.7%，兩組比較差異均無統計學意義(P=0.766)。微創組的1年、3年生存率分彆為90.8%、83.5%，而開胸組分彆為75.8%、66.7%，微創組的長期生存率顯著高于開胸組(P=0.000)。結論與傳統開胸手術相比，胸腔鏡微創手術治療Ⅰ/Ⅱ期非小細胞肺癌的安全性更高，術後恢複快，遠期療效更滿意。
목적：탐토흉강경미창수술치료Ⅰ/Ⅱ기비소세포폐암환자적료효화안전성。방법82례Ⅰ/Ⅱ기비소세포폐암환자채취경향성평분법진행배대，선출60례환자，근거수술방식분위미창조화개흉조，량조각30례。비교량조위수술기적지표이급수방결과。결과관찰조적수술시간、술중출혈량급주원시간균명현소우대조조[(150.8±48.6) min vs (181.6±62.9) min，(162.6±138.5) ml vs (247.6±165.0) ml，(9.1±2.2) min vs (10.8±2.9) min， P<0.05]，량조적술중청소림파결적조수여개수、술후인류시간、위수술기적사망솔급술후병발증발생솔비교차이균무통계학의의(P>0.05)。미창조적1년、3년국부복발솔분별위3.3%、10.0%，이개흉조분별위6.7%、16.7%，량조비교차이균무통계학의의(P=0.704)。미창조적3년、5년원처전이솔분별위10.0%、23.3%，이개흉조분별위16.7%、26.7%，량조비교차이균무통계학의의(P=0.766)。미창조적1년、3년생존솔분별위90.8%、83.5%，이개흉조분별위75.8%、66.7%，미창조적장기생존솔현저고우개흉조(P=0.000)。결론여전통개흉수술상비，흉강경미창수술치료Ⅰ/Ⅱ기비소세포폐암적안전성경고，술후회복쾌，원기료효경만의。
Objective To investigate the effect of minimally invasive thoracoscopic surgery on patients with clinical stageⅠ/Ⅱnon-small cell lung cancer. Methods Eighty-two patients with clinical stageⅠ/Ⅱnon-small cell lung cancer were paired up by the propensity score method. And 60 patients were selected from them and divided into minimally invasive group (n=30) and the thoracotomy group (n=30). Perioperative varivables and follow-up results were compared between the two groups. Results The operative time, operative blood loss and the length of stay of the minimally invasive group were significantly lower than the thoracotomy group [(150.8±48.6) min vs (181.6±62.9) min, (162.6 ± 138.5) ml vs (247.6 ± 165.0) ml, (9.1 ± 2.2) min vs (10.8 ± 2.9) min, all P<0.05]. The differences of mediastinal lymph nodes stations/numbers dissected, postoperative drainage time, perioperative mortality and the incidence of postoperative complications between the two groups were not significant (all P>0.05). The 3-year and 5-year local re-currence rate of the minimally invasive group and the thoracotomy group were 3.3%vs 6.7%and 10.0%vs 16.7%, re-spectively, and the differences between them showed no statistically significant difference (P=0.704). The 3-year and 5-year distant metastasis rate of the minimally invasive group and the thoracotomy group were 10.0%vs 16.7%and 23.3% vs 26.7%, respectively, and the differences between them were not statistically significant (P=0.766). The 3-year and 5-year overall survival of the minimally invasive group and the thoracotomy group were 90.8%vs 83.5%and 75.8% vs 66.7%, respectively. The long-term survival of the minimally invasive group was significantly higher than the thoracotomy group (P=0.000). Conclusion Compared with traditional thoracotomy, thoracoscopic surgery is safer in the treatment of clinical stage Ⅰ/Ⅱ non-small cell lung cancer. It recovers faster after operation and its long-term curative effect is satisfied.
