全胸腔鏡肺葉切除術(shù)治療高齡非小細胞肺癌患者的近期療效及遠期預后影響因素分析

趙鑫　槐梅　張鐿鐳　丁磊

[摘要] 目的 研究分析全胸腔鏡肺葉切除術(shù)治療高齡非小細胞肺癌患者的近期療效及遠期預后影響因素。方法 方便選取赤峰學院附屬醫(yī)院在2015年2月—2016年8月期間收治的122例高齡非小細胞肺癌患者作為研究對象并根據(jù)手術(shù)方式的不同隨機分為觀察組（61例）和對照組（61例），對照組患者給予傳統(tǒng)的開胸肺葉切除術(shù)合淋巴結(jié)清掃術(shù)治療，觀察組患者給予全胸腔鏡肺葉切除術(shù)合淋巴結(jié)清除術(shù)治療，治療后比較觀察組與對照組患者的近期療效及遠期預后影響因素。結(jié)果 觀察組患者術(shù)中出血量（139.53±43.21）mL及術(shù)后引流量（293.23±139.18）mL、手術(shù)時間（148.22±19.28）min及住院總時間（7.51±1.58）d、術(shù)后疼痛程度及不良反應(yīng)發(fā)生率均明顯低于對照組（P<0.05），觀察組患者中位無瘤生存期和復發(fā)轉(zhuǎn)移同對照組比較，差異無統(tǒng)計學意義（P>0.05）。結(jié)論 全胸腔鏡肺葉切除術(shù)治療高齡非小細胞肺癌患者的近期療效值得肯定，且不同手術(shù)方式的遠期療效差異無統(tǒng)計學意義，其臨床分期及組織分化情況是影響患者術(shù)后遠期療效的重要因素。

[關(guān)鍵詞] 胸腔鏡；肺葉切除術(shù)；非小細胞肺癌；近期療效；影響因素

[中圖分類號] R734.2 [文獻標識碼] A [文章編號] 1674-0742（2017）07（c）-0055-03

[Abstract] Objective To research and analyze the influence factors of short-term curative effect and long-term prognosis of complete video-assisted thoracic lobectomy in treatment of senile patients with non-small cell lung cancer. Methods 122 cases of senile patients with non-small cell lung cancer admitted and treated in Affiliated Hopital of Chifeng from February 2015 to August 2016 were convenient selected and randomly divided into two groups with 61 cases in each， the control group were treated with traditional pulmonary lobectomy and lymph node dissection， while the observation group were treated with complete video-assisted thoracic lobectomy and lymph node dissection， and the influence factors of short-term curative effect and long-term prognosis of complete video-assisted thoracic lobectomy in treatment of senile patients with non-small cell lung cancer of the two groups after treatment were analyzed. Results The intraoperative bleeding amount（139.53±43.21）mL， postoperative drainage amount （293.23±139.18）mL， operative time （148.22±19.28）min， total length of stay （7.51±1.58）d and postoperative pains degree and incidence rate of adverse reactions in the observation group were obviously lower than those in the control group（P<0.05）， and there were no obvious differences in the median non-tumor survival stage and recurrence and metastasis between the two groups（P>0.05）. Conclusion The short-term curative effect of complete video-assisted thoracic lobectomy in treatment of senile patients with non-small cell lung cancer is well received and there are no obvious differences in the long-term curative effects between different operative methods， and the clinical stages and tissue differentiation situation are the important influence factors of long-term curative effect after operation.

[Key words] Thoracoscope； Pulmonary lobectomy； Non-small cell lung cancer； Short-term curative effect； Influence factorendprint