论文部分内容阅读
目的:探讨全胸腔镜肺叶切除术治疗早期非小细胞肺癌(NSCLC)患者的疗效及预后状况。方法:选择2010年6月至2013年6月我院收治的早期NSCLC患者80例作为研究对象,随机分为对照组(n=40)和实验组(n=40)。对照组患者行常规开胸肺叶切除术,实验组患者行全胸腔镜肺叶切除术,所有患者于术后视具体情况给予化疗或放疗。记录两组患者术中及术后临床相关指标,术后并发症发生率,术后随访3年,比较两组患者3年生存率,并分析全胸腔镜肺叶切除术后患者预后影响因素。结果:实验组患者手术时间、术中出血量、胸腔引流时间及住院时间均明显低于对照组(P<0.05)。实验组患者术后并发症发生率、术后3年生存率分别为12.50%、57.50%,与对照组的17.50%、50.00%相比,差异均无统计学意义(P>0.05)。Cox多因素分析结果显示,肿瘤直径和术后是否放化疗是影响全胸腔镜肺叶切除术后患者预后的危险因素(P<0.05)。结论:全胸腔镜肺叶切除术治疗早期NSCLC患者具有微创、安全及远期生存率较高的特点,术后辅以放化疗能够延长患者的生存率。
Objective: To investigate the efficacy and prognosis of total thoracoscopic lobectomy for early stage non-small cell lung cancer (NSCLC). Methods: Eighty patients with early stage NSCLC admitted to our hospital from June 2010 to June 2013 were randomly divided into control group (n = 40) and experimental group (n = 40). Patients in the control group underwent routine thoracotomy and lobectomy. Patients in the experimental group underwent thoracoscopic lobectomy. All patients underwent either chemotherapy or radiotherapy after surgery. The intraoperative and postoperative clinical indexes, the incidence of postoperative complications and the 3-year follow-up were recorded. The 3-year survival rates were compared between the two groups. The prognostic factors of patients undergoing thoracoscopic lobectomy were analyzed. Results: The operation time, intraoperative blood loss, chest drainage time and hospital stay in experimental group were significantly lower than those in control group (P <0.05). The incidence of postoperative complications and the 3-year survival rate of the experimental group were 12.50% and 57.50%, respectively, which were not significantly different from those of the control group (17.50% and 50.00%) (P> 0.05). Cox multivariate analysis showed that tumor diameter and postoperative radiotherapy and chemotherapy were the risk factors influencing the prognosis of patients after thoracoscopic lobectomy (P <0.05). Conclusions: Thoracoscopic lobectomy for early NSCLC patients has the characteristics of minimally invasive, safe and long-term survival. Adjuvant chemotherapy and radiotherapy can prolong the survival rate of patients with early-stage NSCLC.