VATS辅助下小切口行肿瘤切除、系统纵隔淋巴结清扫术治疗肺癌的效果(1)
【摘要】 目的：对肺癌治疗中电视辅助胸腔镜手术(video-assisted thoracic surgery，VATS)辅助下小切口行肿瘤切除联合系统纵隔淋巴结清扫术的应用价值进行探讨。方法：选取72例笔者所在医院在2015年9月-2017年9月收治的肺癌患者进行研究，按照随机图表法和均分原则分成对照组和观察组，各36例，分别予以开胸手术和VATS辅助下小切口行肿瘤切除+系统纵隔淋巴结清扫术，比较疾病治疗效果。结果：观察组手术治疗情况优于对照组，差异有统计学意义(P<0.05);两组术前肺功能比较，差异无统计学意义(P>0.05)，观察组术后肺功能指标优于对照组，差异有统计学意义(P<0.05);观察组并发症发生率低于对照组，生活质量评分高于对照组，差异有统计学意义(P<0.05)。结论：予以肺癌患者VATS辅助下小切口肿瘤切除术联合系统纵隔淋巴结清扫术效果明显，安全性高，可予以推广应用。
【关键词】 电视辅助胸腔镜手术 小切口肿瘤切除术 系统纵隔淋巴结清扫术 肺癌 肺功能 生活质量
doi：10.14033/j.cnki.cfmr.2020.03.065 文献标识码 B 文章编号 1674-6805(2020)03-0-03
[Abstract] Objective： To investigate the application value of video-assisted thoracic surgery (VATS) assisted small-incision tumor resection and systematic mediastinal lymph node dissection in the treatment of lung cancer. Method： A total of 72 cases of the patients with lung cancer in our hospital from September 2015 to September 2017 were selected to study. According to the random graph method and the principle of the equipartition were divided into control group and observation group with 36 cases of each， respectively. Open chest surgery and VATS assisted small incision+system of mediastinal lymph nodes were performed. Tumor resection and disease treatment effect were compared. Result： Surgical treatment in the observation group was better than that in the control group (P<0.05). There was no statistically significant difference in preoperative pulmonary function between the two groups (P>0.05). And the postoperative pulmonary function index of the observation group was better than that of the control group， with statistically significant difference (P<0.05). The incidence of complications in the observation group was lower than that in the control group， and the quality of life score was higher than that in the control group， with statistically significant differences (P<0.05). Conclusion： VATS assisted small incision tumor resection combined with systematic mediastinal lymph node dissection for patients with lung cancer is effective and safe， and can be widely used.
[Key words] Video-assisted thoracoscopic surgery Small incision tumor resection Systemic mediastinal lymph node dissection Lung cancer Lung function Quality of life
First-author’s address： Changyang People’s Hospital， Changyang 443500， China
肺癌是多發且较为严重的恶性肿瘤之一，其发病率和死亡率正呈现出明显上升趋势，对现代人的身心健康构成极大影响。该疾病确切发病机制尚不明确，数据研究结果显示，长期吸烟史在肺癌的发生发展中起着重要作用，通常情况下，开始吸烟的年龄越早，出现肺癌的概率就越高。另外，职业与环境接触、电离辐射、空气污染、既往肺部慢性感染同样会诱发此病。相当一部分患者发病初期无明显症状表现，发展过程中可出现咳嗽、咯血或痰中带血、胸闷、气急、声音嘶哑等表现，同时伴随发热、消瘦、恶病质等全身症状，发病过程中可累及皮肤、消化系统、心血管系统、血液系统和中枢神经系统，处理不到位不但会加重患者原有疾病，甚至可能危及患者生命安全[1-3]。现阶段临床多用外科手术方式治疗此病，目的在于切除病灶，延长患者生存期。然而传统开胸手术创伤明显，出血量多，易出现并发症，术后恢复难度大。近些年来，电视辅助胸腔镜手术(video-assisted thoracic surgery，VATS)迅速发展，与传统术式相比，具有创伤小、并发症少、安全性高等优势，易为广大医护人员和患者所接受[4-5]。为更好地发挥VATS的应用价值，笔者所在医院对收治的患者实施VATS辅助下小切口行肿瘤切除+系统纵隔淋巴结清扫术，研究详情和所得结论见下文。, http://www.100md.com(方桓)
【关键词】 电视辅助胸腔镜手术 小切口肿瘤切除术 系统纵隔淋巴结清扫术 肺癌 肺功能 生活质量
doi：10.14033/j.cnki.cfmr.2020.03.065 文献标识码 B 文章编号 1674-6805(2020)03-0-03
[Abstract] Objective： To investigate the application value of video-assisted thoracic surgery (VATS) assisted small-incision tumor resection and systematic mediastinal lymph node dissection in the treatment of lung cancer. Method： A total of 72 cases of the patients with lung cancer in our hospital from September 2015 to September 2017 were selected to study. According to the random graph method and the principle of the equipartition were divided into control group and observation group with 36 cases of each， respectively. Open chest surgery and VATS assisted small incision+system of mediastinal lymph nodes were performed. Tumor resection and disease treatment effect were compared. Result： Surgical treatment in the observation group was better than that in the control group (P<0.05). There was no statistically significant difference in preoperative pulmonary function between the two groups (P>0.05). And the postoperative pulmonary function index of the observation group was better than that of the control group， with statistically significant difference (P<0.05). The incidence of complications in the observation group was lower than that in the control group， and the quality of life score was higher than that in the control group， with statistically significant differences (P<0.05). Conclusion： VATS assisted small incision tumor resection combined with systematic mediastinal lymph node dissection for patients with lung cancer is effective and safe， and can be widely used.
[Key words] Video-assisted thoracoscopic surgery Small incision tumor resection Systemic mediastinal lymph node dissection Lung cancer Lung function Quality of life
First-author’s address： Changyang People’s Hospital， Changyang 443500， China
肺癌是多發且较为严重的恶性肿瘤之一，其发病率和死亡率正呈现出明显上升趋势，对现代人的身心健康构成极大影响。该疾病确切发病机制尚不明确，数据研究结果显示，长期吸烟史在肺癌的发生发展中起着重要作用，通常情况下，开始吸烟的年龄越早，出现肺癌的概率就越高。另外，职业与环境接触、电离辐射、空气污染、既往肺部慢性感染同样会诱发此病。相当一部分患者发病初期无明显症状表现，发展过程中可出现咳嗽、咯血或痰中带血、胸闷、气急、声音嘶哑等表现，同时伴随发热、消瘦、恶病质等全身症状，发病过程中可累及皮肤、消化系统、心血管系统、血液系统和中枢神经系统，处理不到位不但会加重患者原有疾病，甚至可能危及患者生命安全[1-3]。现阶段临床多用外科手术方式治疗此病，目的在于切除病灶，延长患者生存期。然而传统开胸手术创伤明显，出血量多，易出现并发症，术后恢复难度大。近些年来，电视辅助胸腔镜手术(video-assisted thoracic surgery，VATS)迅速发展，与传统术式相比，具有创伤小、并发症少、安全性高等优势，易为广大医护人员和患者所接受[4-5]。为更好地发挥VATS的应用价值，笔者所在医院对收治的患者实施VATS辅助下小切口行肿瘤切除+系统纵隔淋巴结清扫术，研究详情和所得结论见下文。, http://www.100md.com(方桓)
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