曾新敏++++++王晖++++++章志龙++++++胡火利++++++徐兴华++++++陈华

[摘要]目的 观察胸腔镜早期周围型肺癌根治术对患者术后TNF-α、IL-6、IL-10等炎症因及T淋巴亚群的影响。方法 将2012年8月～2015年12月于我院确诊的78例早期周围型肺癌并行手术治疗的患者纳入研究，依据手术方案分为开胸手术组40例、胸腔镜组38例，开胸手术组采用常规开胸术，胸腔镜组采用胸腔镜早期周围型肺癌根治术。观察两组TNF-α、IL-6、IL-10水平的变化情况、术后的一般情况及T淋巴亚群水平的差异。结果 两组患者TNF-α、IL-6、IL-10水平均升高（P<0.05），但组间比较胸腔镜组升幅较低（P<0.05）；胸腔镜组术中出血量更少，住院时间、引流管留置时间均更短，术后下床活动时间更早，差异均有统计学意义（P<0.05），手术时间差异无统计学意义（P>0.05）；胸腔镜组术后CD3、CD4、CD8、CD4/CD8波动幅度更小（P<0.05）；胸腔镜组28 d生存率为2.63%，开胸手术组为5.00%，差异无统计学意义（P>0.05）。结论 胸腔镜治疗早期周围型肺癌与传统开胸术相比，具有效果显著、创伤小、恢复快的特点，值得推广。

[关键词]胸腔镜；早期周围型肺癌；根治术；炎症因子；T淋巴亚群水平；影响

[中图分类号] R734.2 [文献标识码] A [文章编号] 1674-4721（2016）10（c）-0065-04

[Abstract]Objective To observe the effect of radical surgery thoracoscope on TNF alpha，IL-6，IL-10 and the level of T lymphocyte subsets of patients with early peripheral lung cancer.Methods 78 patients with diagnosed early peripheral lung cancer in our hospital from August 2012 to December 2015 underwent surgery were included in the study and divided into open chest surgery group （n=40） and thoracoscopic group （n=38），patients in the open chest surgery group were treated with conventional thoracotomy，while patients in the thoracoscopic group underwent thoracoscopic resection of early peripheral lung cancer.Change of TNF alpha，IL-6，IL-10 in two groups were compared，and general situation and the differences in the levels of T lymphocyte subsets were compared.Results The level of TNF alpha，IL-6，IL-10 of two groups both improved （P<0.05），while change of thoracoscopic group was lower （P<0.05）；intraoperative bleeding was less，hospitalization time，drainage tube indwelling time in the thoracoscopic group was shorter，postoperative ambulation time was earlier，and the differences were statistically significant （P<0.05），there was no statistically significant differences in operative time （P>0.05）；fluctuation amplitude of CD3，CD4，CD8，CD4/CD8 were smaller in the thoracoscopic group （P<0.05）；survival rate of 28 d in the thoracoscopic group was 2.63%，with 5.00% in the open chest surgery group，and the difference was not statistically significant （P>0.05）.Conclusion Compared with conventional thoracotomy，thoracoscopic resection has the characteristics of obvious curative effect，less trauma and quick recovery.It is worth popularizing.

[Key words]Thoracoscope；Early peripheral lung cancer；Radical resection；Inflammation factors；T lymphocyte subgroup level；Impact

周围型肺癌是发生于肺段以下支气管的癌症，发病与吸烟、遗传等因素相关，患者以男性为主[1]。临床症状个体差异较大，早期症状多不明显，早期由于瘤体小，易与其他疾病相混淆，不少患者于体检时才被发现。手术是重要的治疗手段，研究发现尽早的手术治疗能提高患者生存率[2]。传统开胸术存在创伤大，且易诱发感染等并发症，不利于患者病情的康复，使部分免疫力差的患者难以适应[3]。笔者采用胸腔镜早期周围型肺癌根治术治疗早期周围型肺癌效果显著，现报道如下。

1资料与方法

1.1一般资料

将2012年8月～2015年12月于我院确诊的78例早期周围型肺癌并知情同意行手术治疗的患者纳入研究，依据手术方案进行分组，开胸手术组40例，胸腔镜组38例。……