【摘要】：目的:比較單孔與多孔VATS治療早期非小細胞肺癌兩種手術(shù)方式對術(shù)后患者慢性疼痛及生活質(zhì)量的影響,探討單孔VATS在早期肺癌治療中的應(yīng)用前景。研究方法:收集青島大學(xué)醫(yī)學(xué)院附屬醫(yī)院胸外科自2016年4月-2017年4月接受肺癌根治術(shù)的100例患者的臨床資料,其中行單孔胸腔鏡(單孔組)50例,其中男28例,女22例,年齡(58.8±7.3)歲,多孔胸腔鏡(多孔組)50例,其中男31例,女19例,年齡(60.4±8.1)歲,兩組患者均行肺葉切除及系統(tǒng)性淋巴結(jié)清掃術(shù),術(shù)后病理診斷為ⅠA-ⅠB期的非小細胞肺癌。對比兩組的臨床資料,以數(shù)字評分量表(Numerical Rating Scale,NRS)評估兩組患者術(shù)后3月及6月的疼痛情況。應(yīng)用由歐洲癌癥研究與治療組織(European Organization for Research and Treatment,EORTC)開發(fā)的生活質(zhì)量核心問卷量表(Quality of Life-Core 30 Questionnaire,QLQ-C30)評估兩組患者術(shù)前、術(shù)后第3個月及6個月的生活質(zhì)量。研究結(jié)果:兩組患者在年齡、性別、腫瘤所在肺葉、腫瘤病理分期、病理類型、手術(shù)時間、術(shù)中出血量、術(shù)后并發(fā)癥、拔管時間等方面差異無統(tǒng)計學(xué)意義(P0.05),單孔組術(shù)后3個月及6個月NRS評分[(2.12±1.05),(1.05±0.92)]與多孔組[(2.35±1.21),(1.38±0.45)]相當(dāng)(P0.05),結(jié)果表明兩組患者在術(shù)后3月及術(shù)后6月的疼痛程度相當(dāng),且兩組術(shù)后6月疼痛程度均低于術(shù)后3月,QLQ-C30評分顯示兩組患者術(shù)后3月功能領(lǐng)域中的情緒功能方面單孔VATS組(70.2±9.3)優(yōu)于多孔VATS組(59.6±8.7)(P0.05),差異有統(tǒng)計學(xué)意義,兩組患者術(shù)后6月的各項QLQ-C30評分相當(dāng)(P0.05),較術(shù)后3月均有所提高,并接近術(shù)前水平,評分結(jié)果表明單孔組術(shù)后3月生存質(zhì)量高于多孔組,術(shù)后6月兩組生活質(zhì)量相當(dāng),基本恢復(fù)至術(shù)前水平。結(jié)論:1.單孔VATS與多孔VATS對于早期非小細胞肺癌的治療同樣安全可靠,能夠達到相同的手術(shù)效果2.接受單孔VATS肺癌切除術(shù)患者術(shù)后3月生存質(zhì)量優(yōu)于多孔VATS,術(shù)后6月兩組均恢復(fù)至接近術(shù)前水平。相比多孔VATS組,單孔VATS組患者在術(shù)后6月內(nèi)生存質(zhì)量存在優(yōu)勢。3.單孔VATS組肺癌切除術(shù)安全可靠,療效肯定,創(chuàng)傷更小,術(shù)后恢復(fù)更快,在肺癌的外科治療中具有廣闊的應(yīng)用前景。
[Abstract]:Objective: to compare the effects of single pore and porous VATS on chronic pain and quality of life in patients with early non-small cell lung cancer (NSCLC), and to explore the application prospect of single pore VATS in the treatment of early lung cancer. Methods: the clinical data of 100 patients undergoing radical resection of lung cancer in the affiliated Hospital of Medical College of Qingdao University from April 2016 to April 2017 were collected. Among them, 50 patients underwent single hole thoracoscopy (single hole group), including 28 males and 22 females. The age was (58.8 鹵7.3) years old. There were 50 cases of porous thoracoscopy (porous group), including 31 males and 19 females, aged (60.4 鹵8.1) years. Postoperative pathological diagnosis was stage 鈪，

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