CAJ | 학술논문

目的：探讨ⅢA期肺癌胸腔镜辅助小切口( VAMT)治疗后的疗效及远期生存率。方法选择2010年8月至2011年8月冀中能源邢台矿业集团有限责任公司总医院收治的32例ⅢA期肺癌患者作为研究对象,采用随机数字表法分为观察组和对照组,各16例。观察组行VAMT辅助肺癌切除术,对照组采用传统开胸手术。比较两组患者手术一般情况、术后并发症发生率、手术前后患者生活质量以及患者血清醛固酮、多巴胺和皮质醇等应激激素水平；对患者进行3年随访,记录两组患者3年生存率。结果观察组术中出血量显著少于对照组、术后拔管时间显著短于对照组[(174±38) mL比(257±43) mL,(3．5±0．7) d比(5．2±1．3) d](P<0．01),观察组并发症发生率显著低于对照组[18．8%(3/16)比31．2%(5/16)](P<0．05)。手术1个月后观察组癌症治疗功能性量表各维度及总分显著高于对照组( P<0．05或P<0．01)；术后1、3、5 d观察组醛固酮、多巴胺、皮质醇水平显著低于对照组(P<0．05)。对两组患者进行3年随访,观察组中位生存期为18．6个月,对照组为19．1个月,两组比较差异无统计学意义( P>0．05)。结论 VAMT手术治疗中晚期肺癌,能取得与传统开胸手术相似的疗效,且对患者创伤小,患者术后生活质量更高,是一种安全、有效的肺癌手术治疗手段。
목적：탐토ⅢA기폐암흉강경보조소절구( VAMT)치료후적료효급원기생존솔。방법선택2010년8월지2011년8월기중능원형태광업집단유한책임공사총의원수치적32례ⅢA기폐암환자작위연구대상,채용수궤수자표법분위관찰조화대조조,각16례。관찰조행VAMT보조폐암절제술,대조조채용전통개흉수술。비교량조환자수술일반정황、술후병발증발생솔、수술전후환자생활질량이급환자혈청철고동、다파알화피질순등응격격소수평；대환자진행3년수방,기록량조환자3년생존솔。결과관찰조술중출혈량현저소우대조조、술후발관시간현저단우대조조[(174±38) mL비(257±43) mL,(3．5±0．7) d비(5．2±1．3) d](P<0．01),관찰조병발증발생솔현저저우대조조[18．8%(3/16)비31．2%(5/16)](P<0．05)。수술1개월후관찰조암증치료공능성량표각유도급총분현저고우대조조( P<0．05혹P<0．01)；술후1、3、5 d관찰조철고동、다파알、피질순수평현저저우대조조(P<0．05)。대량조환자진행3년수방,관찰조중위생존기위18．6개월,대조조위19．1개월,량조비교차이무통계학의의( P>0．05)。결론 VAMT수술치료중만기폐암,능취득여전통개흉수술상사적료효,차대환자창상소,환자술후생활질량경고,시일충안전、유효적폐암수술치료수단。
Objective To explore the efficacy and survival ofⅢA stage lung cancer treated with video-assisted mini-thoracotomy( VAMT) . Methods A total of 32 ⅢA stage lung cancer patients admitted to izhong Energy Xingtai MIG General Hospital from Aug. 2010 to Aug. 2011 were randomly divided into the observation group(16 cases) and control group(16 cases). The observation group underwent VAMT,the con-trol group received traditional open chest operation. The general operation situation,the incidence of postoper-ative complications,life quality and serum aldosterone,dopamine and cortisol levels before and after operation of the two groups were compared,and the patients were followed up for 3 years,and 3 years survival rate of the two groups was recorded. Results Intraoperative bleeding,postoperative extubation time in the observa-tion group were significantly lower than the control group[(174 ±38) mL vs (257 ±43) mL,(3.5 ±0.7) d vs (5.2 ±1.3) d] (P<0.01),the complication rate of the observation group was significantly lower than the control group [18. 8%(3/16) vs 31. 2%(5/16)](P<0. 05). 1 month after surgery FACT-L scale dimen-sions and total score in the observation group were significantly higher than the control group ( P<0. 05 or P<0. 01);the levels of aldosterone,dopamine and cortisol after 1,3,5 d in the observation group were sig-nificantly lower than the control group(P<0. 05). Patients were followed up for 3 years,the median survival in the observation group was 18. 6 months,19. 1 months in the control group,the two groups had no signifi-cant difference(P>0. 05). Conclusion VAMT assisted small incision in the treatment of advanced lung cancer,can obtain similar efficacy with traditional open chest surgery, with higher postoperative living quality,thus is a safe and effective surgical treatment of lung cancer.