林洁桓福建省龙岩市第一医院心胸外科，福建龙岩　364000

胸腔镜与开胸手术治疗早期非小细胞肺癌的临床疗效观察

林洁桓
福建省龙岩市第一医院心胸外科，福建龙岩364000

目的通过比较胸腔镜与开胸手术治疗早期非小细胞肺癌的临床疗效，回顾性分析胸腔镜在早期非小细胞肺癌手术治疗中的优势。 方法纳入2008年3月～2015年10月早期非小细胞肺癌患者208例，按手术方法不同将其分为胸腔镜手术组104例与开胸手术组104例。开胸手术组患者行开胸手术（或胸腔镜辅助小切口，约12 cm）；胸腔镜手术组患者行完全胸腔镜手术，对比两组患者手术出血量、淋巴结清扫总数、术后引流量、引流管留置时间、VAS评分、住院时间、并发症发生率。 结果胸腔镜手术组并发症发生率11.54%，明显低于开胸手术组的25.96%。胸腔镜手术组手术出血量、术后引流量、引流管留置时间、VAS评分、住院时间分别为（78.47±14.29）mL、（167.64±14.34）mL、（2.64±0.34）d、（3.47±0.29）分和（7.87±1.19）d；开胸手术组分别为（192.89±13.62）mL、（273.45± 93.839）mL、（4.45±1.83）d、（7.89±0.62）分、（14.95±3.36）d，差异有统计学意义（P＜0.05）。两组患者淋巴结清扫总数，胸腔镜手术组为（15.64±4.34）个，开胸手术组为（15.45±3.83）个，差异无统计学意义（P＞0.05）。结论胸腔镜与开胸手术治疗早期非小细胞肺癌的临床疗效确切，均可有效清扫淋巴结，但胸腔镜手术有微创性，更安全，可减少术中出血和术后并发症，减轻患者痛苦，缩短术后引流时间和康复时间，值得推广。

胸腔镜；开胸手术；早期非小细胞肺癌；并发症

［Abstract］Objective To compare the c1inica1 efficacy of thoracic and thoracic surgery in the treatment of ear1y stage non-sma11 ce11 1ung cancer，and to exp1ore the advantages of video assisted thoracic surgery in the surgica1 treatment of ear1y stage non-sma11 ce11 1ung cancer.Methods 208 cases of non-sma11 ce11 1ung cancer patients from March 2008 to October 2015 were se1ected，according to the operation method，they were divided into 104 cases of thoracic surgery group and 104 cases of open chest operation group.Open chest surgery group patients underwent open chest surgery（or video assisted sma11 incision，about 12 cm）；video assisted thoracic surgery in patients undergoing thoracic surgery，the amount of b1eeding，the tota1 number of 1ymph node dissection，postoperative drainage vo1ume，indwe11ing time of drainage tube，VAS score，hospita1 stay，incidence of comp1ications were compared between two groups.Results The incidence rate of comp1ications in the thoracic surgery group was 11.54%，which 1ower than that in the open chest surgery group（25.96%）.After thoracoscopic surgery operative b1eeding vo1ume，postoperative drainage，drainage tube indwe11ing time，VAS score，hospita1ization time were（78.47±14.29）mL，（167.64±14.34）mL，（2.64±0.34）d，（3.47±0.29）scores and（7.87±1.19）d；open chest surgery group，respective1y（192.89±13.62）mL，（273.45±93.839）mL and（4.45± 1.83）d，（7.89±0.62）scores，（14.95±3.36）d，the difference was statistica11y significant（P＜0.05）.Two groups of patients with tota1 number of 1ymph node dissection had no significant difference，thoracoscopic surgery group（15.64±4.34），thoracotomy group（15.45±3.83），the difference was not statistica11y significant（P＞0.05）.Conclusion The c1inica1 efficacy of thoracic surgery in patients with ear1y non-sma11 ce11 1ung cancer is accurate，can effective1y c1ean the 1ymph nodes，but the thoracic surgery is minima11y invasive，more safe，can reduce b1eeding and postoperative comp1ications，reduce the pain of patients，shorten the drainage time and rehabi1itation time，it is worth promoting.

［Key words］Thoracic surgery；Thoracic surgery；Ear1y stage non-sma11 ce11 1ung cancer；Comp1ication

非小细胞肺癌为常见肿瘤，其发病率随着环境恶化、吸烟、废气吸入等因素影响而逐年升高，对人们身心健康造成严重威胁［1］。……