本文選題：單操作孔 + 胸腔鏡　； 參考：《南昌大學(xué)》2015年碩士論文

【摘要】：目的:通過(guò)臨床研究評(píng)價(jià)單操作孔胸腔鏡肺癌根治術(shù)后近期的療效,探討單操作孔胸腔鏡行肺癌根治性手術(shù)的安全性、可行性及其臨床意義。并調(diào)查肺癌手術(shù)后患者生存質(zhì)量的變化情況,比較單操作孔手術(shù)和“三孔法”手術(shù)對(duì)患者生存質(zhì)量影響的差異。方法:選取2013年4月一2014年11月在我院胸外科擇期行單操作孔胸腔鏡肺葉切除術(shù)治療肺癌患者48例(“兩孔法”組),并與56例同期行“三孔法”胸腔鏡肺葉切除術(shù)治療肺癌的患者(“三孔法”組)進(jìn)行對(duì)比。比較兩組患者的手術(shù)時(shí)間、術(shù)中出血量、術(shù)中清掃淋巴結(jié)數(shù)目、術(shù)后疼痛、術(shù)后下床活動(dòng)時(shí)間、術(shù)后拔除胸腔引流管時(shí)間、術(shù)后并發(fā)癥的發(fā)生情況、住院時(shí)間及術(shù)前和術(shù)后生存質(zhì)量。結(jié)果:所有手術(shù)過(guò)程均順利,圍術(shù)期均無(wú)死亡患者�！皟煽追ā苯M與“三孔法”組手術(shù)時(shí)間分別為(2.67±0.56)h vs(2.62±0.61)h,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)中清掃淋巴結(jié)數(shù)目分別為(14.4±2.3)個(gè)vs(14.1±2.6)個(gè),差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)中出血量分別為(178.7±62.2)m L vs(185.4±69.5)m L,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后下床活動(dòng)時(shí)間分別為(11.2±1.3)h vs(15.7±1.9)h,差異有統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后拔除胸腔引流管時(shí)間分別為(3.3±1.4)天vs(4.7±1.5)天,差異有統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后疼痛分別為(4.9±1.7)分vs(5.8±1.4)分,差異有統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后并發(fā)癥發(fā)生率(12/48)vs(15/56),差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后住院天數(shù)(5.1±0.9)天vs(6.4土1.2)天,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后3個(gè)月隨訪調(diào)查發(fā)現(xiàn),經(jīng)手術(shù)治療的兩組患者術(shù)后生活質(zhì)量均較術(shù)前有明顯提高,另外,我們觀察到“兩孔法”組患者術(shù)后3個(gè)月的生理狀況、功能狀況及總計(jì)方面的得分要優(yōu)于“三孔法”組。結(jié)論:單操作孔胸腔鏡肺葉切除術(shù)治療肺癌是一種非常有價(jià)值的手術(shù)方式,其在安全性、損傷程度、康復(fù)速度和術(shù)后生存質(zhì)量等方面較“三孔法”胸腔鏡肺葉切除肺癌的治療方面更有優(yōu)勢(shì),值得推廣。
[Abstract]:Objective: to evaluate the short-term curative effect of single hole thoracoscopic surgery on lung cancer, and to explore the safety, feasibility and clinical significance of single hole thoracoscopic surgery for lung cancer.The changes of quality of life (QOL) of lung cancer patients after operation were investigated, and the difference between single-hole operation and "three-hole" operation on quality of life (QOL) was compared.Methods: from April 2013 to November 2014, 48 patients with lung cancer were treated by single hole thoracoscopic lobectomy in our hospital from April 2013 to November 2014, and 56 patients were treated with thoracoscopic lobectomy with "three holes method" at the same time.Surgical treatment of lung cancer patients (the "three hole method" group) were compared.The time of operation, the amount of blood lost during operation, the number of lymph nodes dissected, the postoperative pain, the time of getting out of bed after operation, the time of pulling out the thoracic drainage tube, the incidence of postoperative complications were compared between the two groups.Length of stay and quality of life before and after operation.Results: all the surgical procedures were smooth, and no patients died during the perioperative period.The operative time of the "two-hole method" group and the "three-hole method" group were 2.67 鹵0.56 vs(2.62 鹵0.61 h, respectively, with no significant difference (P 0.05), and the number of dissected lymph nodes during operation was 14.4 鹵2.3 vs(14.1 鹵2.6, respectively.There was no significant difference in blood loss during operation (178.7 鹵62.2mL vs(185.4 鹵69.5ml / L), there was no significant difference between the two groups (P 0.05), the time of getting out of bed after operation was 11.2 鹵1.3h vs(15.7 鹵1.9mh, the difference was significant (P0.05d), the time of extubation of thoracic drainage tube was 3.3 鹵1.4d vs(4.7 鹵1.5d, respectively.The difference was statistically significant (P 0.05); postoperative pain was 4.9 鹵1.7 (vs(5.8 鹵1.4), the difference was statistically significant (P 0.05); the incidence of postoperative complications was 12 / 48 vs 15 / 56, the difference was not statistically significant (P 0.05); the postoperative hospital stay was 5. 1 鹵0. 9 days vs(6.4 = 1.2) days, the difference was statistically significant (P 0. 05).A follow-up study of 3 months after operation showed that the postoperative quality of life in the two groups was significantly higher than that in the pre-operation group. In addition, we observed the physiological status of the patients in the "two-hole method" group 3 months after operation.Functional status and total score were better than the three-hole method group.Conclusion: single hole thoracoscopic lobectomy is a valuable surgical method for the treatment of lung cancer.The speed of rehabilitation and quality of life after operation are better than that of "three holes" thoracoscopic lobectomy for lung cancer, which is worth popularizing.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R734.2

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