CAJ | 학술논문

目的：探讨周围型小肺癌的TNM分期对于微创手术治疗预后的指导价值。方法选择180例周围型小肺癌患者，其中T1期肺癌20例、T2期肺癌40例、T3期肺癌80例、T4期肺癌40例。所有患者接受以微创手术为主的综合治疗，观察术后近远期疗效。结果 T1期、T2期、T3期、T4期患者的近期有效率分别为90．0％、80．0％、75．0％和62．5％，组间对比差异有统计学意义（P＜0．05）。 T1期肺癌与T2期肺癌患者术后的感染、出血、恶心呕吐等并发症总体发生率明显低于其他患者（P＜0．05）。不同TNM分期患者的疼痛、日常生活、活动范围与力量评分对比差异都有统计学意义（P＜0．05），随着TNM分期的增加，评分呈现明显下降的趋势。所有患者术后随访2年，T1期、T2期、T3期、T4期患者的2年生存率分别为95．0％，90．0％，80．0％和52．5％，组间对比差异有统计学意义（ P＜0．05）。结论采用微创手术治疗周围型小肺癌的近期疗效比较好，TNM分期的应用能辅助指导手术应用与预后判断。随着TNM分期的增加，患者的预后越来越差。
목적：탐토주위형소폐암적TNM분기대우미창수술치료예후적지도개치。방법선택180례주위형소폐암환자，기중T1기폐암20례、T2기폐암40례、T3기폐암80례、T4기폐암40례。소유환자접수이미창수술위주적종합치료，관찰술후근원기료효。결과 T1기、T2기、T3기、T4기환자적근기유효솔분별위90．0％、80．0％、75．0％화62．5％，조간대비차이유통계학의의（P＜0．05）。 T1기폐암여T2기폐암환자술후적감염、출혈、악심구토등병발증총체발생솔명현저우기타환자（P＜0．05）。불동TNM분기환자적동통、일상생활、활동범위여역량평분대비차이도유통계학의의（P＜0．05），수착TNM분기적증가，평분정현명현하강적추세。소유환자술후수방2년，T1기、T2기、T3기、T4기환자적2년생존솔분별위95．0％，90．0％，80．0％화52．5％，조간대비차이유통계학의의（ P＜0．05）。결론채용미창수술치료주위형소폐암적근기료효비교호，TNM분기적응용능보조지도수술응용여예후판단。수착TNM분기적증가，환자적예후월래월차。
Objective To investigate the guidance value of TNM staging on prognosis of small peripheral lung cancer treated with minimally invasive surgery.Methods 180 small peripheral lung cancer patients,including 20 cases of stage T1 lung cancer,40 cases of stage T2 lung cancer,80 cases of stage T3 lung cancer,40 cases of stage T4 lung cancer were selected,All pa-tients received minimally invasive surgery,the postoperative short-and long-term efficacy were observed.Results The response rate of stage T1,T2,T3,T4 patients were 90.0%,80.0%,75.0% and 62.5%,respectively,there had statistically significant difference(P<0.05).The postoperative infection,bleeding,nausea and vomiting of stage T1,T2 patients were significantly lower than other patients(P<0.05).There had statistically significant difference in pain,daily life,the scope of activities and power ratings scores in patients with different TNM staging(P<0.05),with the increase in TNM staging,the scores showed significant decline.All patients were followed up for 2 years,the survival rates of stage T1,T2,T3,T4 patients were 95.0%,90.0%,80.0%and 52.5%,respectively,there had statistically significant difference ( P<0.05) .Conclusion Minimally invasive surgery for small peripheral lung cancer has good short-term efficacy,TNM stage can help guide the surgical applications and prognosis.With the increase of TNM staging,the prognosis is worse.