徐宝宁，宋成洋，邹孔军，田大力(中国医科大学附属第四医院，沈阳110032)

电视胸腔镜辅助微创切口肺癌根治术治疗非小细胞肺癌的临床效果

徐宝宁，宋成洋，邹孔军，田大力
(中国医科大学附属第四医院，沈阳110032)

摘要:目的探讨电视胸腔镜辅助微创切口肺癌根治术治疗非小细胞肺癌的临床效果及预后。方法回顾性分析95例电视胸腔镜辅助微创切口肺癌根治术(微创组)与94例传统开胸肺癌根治术(常规组)患者的临床资料，对比两组疗效及预后。结果微创组术中出血量、引流管留置时间、镇痛药使用次数、术后并发症及术后住院时间均少于常规组(P均＜0.05);两组手术时间、淋巴结清除数差异无统计学意义(P均＞0.05);两组术后无疾病进展生存期和总生存期差异无统计学意义(P均＞0.05)。结论电视胸腔镜辅助微创切口肺癌根治术治疗非小细胞肺癌可完成肿瘤的彻底切除和系统淋巴结清扫，在远期疗效上亦不逊于常规开胸手术，且创伤小、恢复快。

关键词:肺肿瘤;胸腔镜;围手术期;预后

Clinical research about video-assistedmini-thoracotomy in treatment of non-small-cell lung cancer

XU Bao-ning，Song Cheng-yang，ZOU Kong-jun，Tianda-li
(The Fourth Affiliated Hospital of Chinamedical University，Shenyang 110032，China)

Abstract:Objective To investigate the clinical efficacy of video-assistedmini-thoracotomy(VAMT)in the treatment of non-small-cell lung cancer(NSCLC)and the prognosis.Methods Ninety-five patients treated with VAMT(minimally invasive group)and 94 patients treated with conventional thoracotomy(conventional group)received the radical resection of pulmonary carcinoma.The clinicaldata of the two groups were retrospectively analyzed and we compared the curative effect and the prognosis of the two groups.Results The blood loss，drainage tube indwelling time，the frequency of using analgesics，postoperative complications and postoperative hospital stay in patients of theminimally invasive group were less than those of the conventional group，and significantdifference was found between the two groups(all P＜0.05).No statistically significantdifferences were found in the operative time and the number of lymph nodes removed between the two groups(all P＞0.05).There were no significantdifferences in the overall survival after surgery and progression-free survival between the two groups(all P＞0.05).Conclusions VAMT in the treatment of NSCLC can complete the radical resection of the tumor and the lymph node system.The long-term effect of VAMT is not inferior to the conventional thoracotomy，including less trauma and faster recovery.

Key words:video-assistedmini-thoracotomy; non-small-cell lung cancer; perioperative period;prognosis

肺癌是全球范围内发病率及病死率最高的恶性肿瘤［1，2］。非小细胞肺癌(NSCLC)是最常见的肺癌类型，约占全部肺癌的80%［3］。目前NSCLC的治疗是以手术为主的多学科联合的综合治疗。自20世纪90年代以来，电视胸腔镜手术已逐渐成为胸外科的一项常见手术方式，但其手术适应证较严格。电视胸腔镜辅助微创切口肺癌根治术(VAMT)很好地结合了单纯电视胸腔镜手术和传统开胸手术的优点，对机体创伤小，使患者疼痛轻、术后恢复快［4］。……