朱秣含

【摘要】 目的：观察与比较不同手术方式对肺癌根治术患者血清趋化因子及选择素指标表达的影响。方法：选取2017年2月-2019年12月本院收治的90例肺癌根治术患者为研究对象，将其随机分为A组（采取开胸手术）和B组（采取胸腔镜手术），每组45例。比较两组术后不同时间的疼痛程度（VAS评分）、手术前后的血清炎症介质、趋化因子及选择素指标水平。结果：术后6、12、24、72 h，B组的VAS评分均显著低于A组，差异均有统计学意义（P<0.05）。术前两组的血清炎症介质、趋化因子及选择素指标水平比较，差异均无统计学意义（P>0.05）;术后1、3、5 d，B组的血清炎症介质、趋化因子及选择素指标水平均显著低于A组，差异均有统计学意义（P<0.05）。结论：胸腔镜肺癌根治术患者围术期的疼痛程度较轻，炎性因子、血清趋化因子及选择素控制较好，临床应用价值较高。

【关键词】 开胸手术 胸腔镜手术 肺癌根治术 趋化因子 选择素

[Abstract] Objective： To observe and compare the influence of different operation methods for serum chemokines and selectin expression of patients with radical resection for lung cancer. Method： A total of 90 patients with radical resection for lung cancer from February 2017 to December 2019 were chosen for the study， and they were randomly divided into group A （open operation） and group B （thoracoscopic operation） with 45 cases in each group. The pain degree （VAS score） at different time after the operation， serum inflammatory mediators， chemokines and selectin expression before and after the operation of two groups were compared. Result： The VAS scores of group B at 6 h， 12 h， 24 h and 72 h after the operation were significantly lower than those of group A， there were statistically significant differences （P<0.05）. The serum inflammatory mediators， chemokines and selectin expression of two groups before the operation were compared， there were no statistically significant differences （P>0.05）; the serum inflammatory mediators， chemokines and selectin expression of group B at 1， 3 and 5 d after the operation were significantly lower than those of group A，there were statistically significant differences （P<0.05）. Conclusion： Patients undergoing thoracoscopic radical resection of lung cancer has less perioperative pain， better control of inflammatory cytokines， serum chemokines and selectin， and higher clinical application value.

[Key words] Open operation Thoracoscopic operation Radical resection for lung cancer Chemokines Selectin

First-authors address： The Third Peoples Hospital of Yingkou City， Yingkou 115000， China

doi：10.3969/j.issn.1674-4985.2021.08.005

肺癌的治疗方式中，根治性手术是常见的有效方式，而手术作为有创性治疗方式，其对患者围术期的影响较大，除疼痛等不适感情况外，炎性反应也是表现突出的方面，而趋化因子及选择素的表达则与疼痛及机体炎性反应等均密切相关，同时其也与本病密切相关，因此对肺癌根治术患者进行上述指标表达的监测价值较高[1-2]。本研究就不同手术方式对肺癌根治术患者血清趋化因子及选择素指标表达的影响进行探究，以为本类患者手术方式的選择提供参考依据，现报道如下。

1 资料与方法

1.1 一般资料 选取2017年2月-2019年12月本院收治的90例肺癌根治术患者为研究对象，纳入标准：20岁及以上者;符合肺癌根治术手术指征者。排除标准：合并创伤者;合并感染者;合并慢性基础疾病者;合并代谢性疾病者。将患者随机分为A组和B组，每组45例。……