全胸腔鏡與小切口開胸肺癌根治術治療早期非小細胞肺癌的臨床對比研究
發(fā)布時間：2019-04-25 21:16
【摘要】：[目的]比較完全胸腔鏡下(c-VATS)肺癌根治術與小切口開胸(MIT)肺癌根治術治療早期非小細胞肺癌(NSCLC)的手術情況,為胸外科肺癌手術患者術式的選擇提供理論依據(jù)。[方法]選擇2013年6月-2016年8月在昆明醫(yī)科大學第二附屬醫(yī)院胸心血管外科住院并接受手術治療的早期非小細胞肺癌患者122例,按手術方式分為c-VATS組和小切口開胸組。c-VATS組患者58例,該組患者行c-VATS下肺癌根治術;小切口開胸組患者64例,該組患者行MIT肺癌根治術。比較兩組患者的手術時長、術中出血量、清掃淋巴結個數(shù)、術后第一天引流量、引流時間、住院費用、住院總天數(shù)、術后3個月和術后6個月復發(fā)情況等臨床相關指標。應用SPSS22.0統(tǒng)計軟件進行分析,計量資料以均數(shù)士標準差(x±S)表示,符合正態(tài)性的數(shù)據(jù)采用獨立樣本t檢驗進行分析,不服從正態(tài)性的采用非參數(shù)檢驗,計數(shù)資料采用卡方檢驗進行組間差異性分析。以P0.05為差異有統(tǒng)計學意義。[結果]兩組患者順利完成手術,無圍手術期死亡病例,在接受后續(xù)治療后均康復出院。c-VATS組患者手術時長(260.07±77.663)、術中清掃淋巴結個數(shù)(11.19±1.572)與開胸組手術時長(249.77±81.592)、術中清掃淋巴結個數(shù)(11.31±1.612)相比無顯著差異,其結果無統(tǒng)計學意義(P0.05); c-VATS組患者術中出血量、術后第一天胸管引流量、引流時間、并發(fā)癥發(fā)生率、住院總天數(shù)均低于開胸組,其差異有統(tǒng)計學意義(P0.05);而c-VATS組患者住院費用(39135.64±11125.783)高于開胸組(33827.05±13239.753),其差異有統(tǒng)計學意義(P0.05)。[結論]與小切口開胸手術相比,c-VATS肺癌根治術是臨床上治療非小細胞肺癌的有效手段,它具有術中創(chuàng)傷小、術后恢復快且并發(fā)癥發(fā)生率低等優(yōu)點,能進一步減少病人手術痛苦和縮短病人住院時間,適合臨床推廣。但是c-VATS肺癌根治術手術費用較小切口開胸手術高,對于一些家庭經(jīng)濟條件較為困難的患者而言,需酌情選擇。
[Abstract]:[objective] to compare the results of total thoracoscopic (c-VATS) radical resection of lung cancer with small thoracotomy for (MIT) lung cancer in the treatment of early non-small cell lung cancer (NSCLC), so as to provide a theoretical basis for the choice of surgical procedures for patients with thoracic surgical lung cancer. [methods] from June 2013 to August 2016, 122 patients with early non-small cell lung cancer were admitted to the Department of Cardiovascular surgery of the second affiliated Hospital of Kunming Medical University. The patients were divided into c-VATS group and small incision thoracotomy group according to the operation mode. 58 patients in c-VATS group were treated with radical resection of lung cancer under c-VATS. 64 patients in the small incision thoracotomy group were treated with MIT lung cancer radical surgery. The length of operation, the amount of bleeding during operation, the number of lymph node dissection, the drainage flow on the first day after operation, the time of drainage, the cost of hospitalization, the total number of days in hospital, the recurrence of postoperative 3 months and 6 months after operation were compared between the two groups. The SPSS22.0 statistical software was used to analyze the data, and the measured data were expressed as the mean-plus-standard deviation (x-plus S). The normal data were analyzed by independent sample t-test, and the non-parametric test was used for the non-compliance with normality. Chi-square test was used to analyze the differences between groups. The difference was statistically significant (P0.05). [results] two groups of patients successfully completed the operation, there were no perioperative death cases, after receiving follow-up treatment, all recovered from hospital. The operation time in c-VATS group was (260.07 鹵77.663), and the time of operation in c-group was (260.07 鹵77.663). There was no significant difference in the number of lymph nodes between the two groups (11.19 鹵1.572), (249.77 鹵81.592) and (11.31 鹵1.612) in the thoracotomy group, and there was no significant difference between the two groups (P0.05). The volume of intraoperative bleeding, drainage time, complications and total days of hospitalization in the c-VATS group were significantly lower than those in the thoracotomy group on the first day after operation (P0.05). The cost of hospitalization in c-VATS group (39135.64 鹵11125.783) was significantly higher than that in open chest group (33827.05 鹵13239.753) (P0.05). [conclusion] compared with small incision thoracotomy, radical resection of c-VATS lung cancer is an effective method for the treatment of non-small cell lung cancer. It has the advantages of less trauma, faster recovery and lower incidence of complications. It can further reduce the pain of operation and shorten the hospitalization time of patients, so it is suitable for clinical popularization. However, the cost of radical operation of c-VATS lung cancer is higher than that of small incision thoracotomy. For some patients with difficult family economic conditions, it is necessary to choose at their own discretion.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R734.2
[Abstract]:[objective] to compare the results of total thoracoscopic (c-VATS) radical resection of lung cancer with small thoracotomy for (MIT) lung cancer in the treatment of early non-small cell lung cancer (NSCLC), so as to provide a theoretical basis for the choice of surgical procedures for patients with thoracic surgical lung cancer. [methods] from June 2013 to August 2016, 122 patients with early non-small cell lung cancer were admitted to the Department of Cardiovascular surgery of the second affiliated Hospital of Kunming Medical University. The patients were divided into c-VATS group and small incision thoracotomy group according to the operation mode. 58 patients in c-VATS group were treated with radical resection of lung cancer under c-VATS. 64 patients in the small incision thoracotomy group were treated with MIT lung cancer radical surgery. The length of operation, the amount of bleeding during operation, the number of lymph node dissection, the drainage flow on the first day after operation, the time of drainage, the cost of hospitalization, the total number of days in hospital, the recurrence of postoperative 3 months and 6 months after operation were compared between the two groups. The SPSS22.0 statistical software was used to analyze the data, and the measured data were expressed as the mean-plus-standard deviation (x-plus S). The normal data were analyzed by independent sample t-test, and the non-parametric test was used for the non-compliance with normality. Chi-square test was used to analyze the differences between groups. The difference was statistically significant (P0.05). [results] two groups of patients successfully completed the operation, there were no perioperative death cases, after receiving follow-up treatment, all recovered from hospital. The operation time in c-VATS group was (260.07 鹵77.663), and the time of operation in c-group was (260.07 鹵77.663). There was no significant difference in the number of lymph nodes between the two groups (11.19 鹵1.572), (249.77 鹵81.592) and (11.31 鹵1.612) in the thoracotomy group, and there was no significant difference between the two groups (P0.05). The volume of intraoperative bleeding, drainage time, complications and total days of hospitalization in the c-VATS group were significantly lower than those in the thoracotomy group on the first day after operation (P0.05). The cost of hospitalization in c-VATS group (39135.64 鹵11125.783) was significantly higher than that in open chest group (33827.05 鹵13239.753) (P0.05). [conclusion] compared with small incision thoracotomy, radical resection of c-VATS lung cancer is an effective method for the treatment of non-small cell lung cancer. It has the advantages of less trauma, faster recovery and lower incidence of complications. It can further reduce the pain of operation and shorten the hospitalization time of patients, so it is suitable for clinical popularization. However, the cost of radical operation of c-VATS lung cancer is higher than that of small incision thoracotomy. For some patients with difficult family economic conditions, it is necessary to choose at their own discretion.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R734.2
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