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目的对比完全电视胸腔镜单操作孔法和完全电视胸腔镜3孔法分别行肺叶切除术在治疗早期非小细胞肺癌的临床疗效差异,为该类手术方法的选择提供理论基础。方法选取2014年2月至2016年6月早期非小细胞肺癌患者82例作为研究对象。采用完全电视胸腔镜单操作孔行肺叶切除术者为单操作孔组(n=41),采用完全电视胸腔镜3孔法行肺叶切除手术者为3孔法组(n=41)。比较两组患者手术质量(手术时间、术后下床活动时间、住院时间、术中出血量、术后总引流量、术后拔管时间)、手术疗效(淋巴结清扫数量、术后并发症、术后疼痛VAS评分)、手术疗效满意情况。结果两组均无手术期间死亡病例。单操作孔组手术时间、术中出血量、术后下床活动时间、术后总引流量、住院时间及术后拔管时间明显优于3孔法组(P<0.05,P<0.01);单操作孔组淋巴结清扫数量多于3孔法组(P<0.01),术后并发症发生率低于3孔法组(P<0.05);随着时间的延长,两组疼痛VAS评分均逐渐显著减小(P均<0.01);单操作孔组术后1、3、5 d的疼痛VAS评分低于3孔法组(P均<0.01)。两组手术满意情况比较差异无统计学意义(P>0.05)。结论完全胸腔镜单操孔手术行肺叶切除治疗早期非小细胞肺癌有较好的临床效果,具有创伤小、术中出血量及总引流量少、拔除引流管时间及术后住院时间短、患者术后疼痛较轻的优势。
Objective To compare the clinical curative effects of total lobectomy alone and three-hole video-assisted thoracoscopic lobectomy for the treatment of early non-small cell lung cancer, and to provide a theoretical basis for the selection of such surgical methods. Methods 82 patients with early stage non-small cell lung cancer from February 2014 to June 2016 were selected as the research object. Patients undergoing total lobectomy with a single operation hole underwent lobectomy for a single operation hole group (n = 41), and a full VATS thoracoscopic 3-hole procedure for lobectomy operation (n = 41). The operation quality (number of operation, postoperative ambulation time, hospital stay, intraoperative blood loss, postoperative total drainage volume and postoperative extubation time) was compared between the two groups. Surgical efficacy (number of lymph node dissection, postoperative complications, Postoperative pain VAS score), satisfactory surgical results. Results There were no deaths during the operation in both groups. The operation time, intraoperative blood loss, postoperative ambulation time, postoperative total drainage, hospital stay and postoperative extubation time were significantly better in the single operation group than those in the three - hole group (P <0.05, P <0.01). The number of lymph node dissection in the single operation group was more than that in the 3-hole group (P <0.01), and the incidence of postoperative complications was lower than that in the 3-hole group (P <0.05). The pain VAS scores gradually increased with time (P <0.01). The VAS score of pain in single operation group was lower than that in 3-hole group on the 1st, 3rd, 5th day after operation (P <0.01). There was no significant difference between the two groups in the surgical satisfaction (P> 0.05). Conclusions Complete thoracoscopic single-hole surgery for lobectomy for early non-small cell lung cancer has a good clinical effect, with less trauma, less blood loss and total drainage, drainage tube removal time and shorter postoperative hospital stay, patients The advantage of less postoperative pain.