黄文海　　林志潮　　谢泽华　　易永盛

[關键词] 胸腔镜肺叶切除术;肺段切除术;早期肺癌;肺功能

[中图分类号] R734.2          [文献标识码] B          [文章编号] 1673-9701（2021）16-0072-03

The difference of curative effect between thoracoscopic lobectomy and segmentectomy in the treatment of early lung cancer

HUANG Wenhai   LIN Zhichao   XIE Zehua   YI Yongsheng

Department of Thoracic Surgery， Jiangmen Central Hospital in Guangdong Province， Jiangmen   529000， China

[Abstract] Objective To compare the efficacy and safety of thoracoscopic lobectomy and segmentectomy in the treatment of early lung cancer. Methods A total of 180 patients with early lung cancer who received surgical treatment in our hospital from August 2017 to June 2019 were selected and grouped by the random number table method， with 90 patients in each group. The observation group was treated with pulmonary segmentectomy， and the control group was treated with thoracoscopic lobectomy. The clinical efficacy of the two surgical methods was compared. Results There was no significant difference of the operation time，intraoperative blood loss， the number of dissected lymph nodes and the postoperative indwelling time of the chest tube between the two groups（P>0.05）. The thoracic drainage volume in the observation group was （1058.56±105.28） mL， which was lower than that of （1395.47±106.53）mL in the control group， and the difference between the two groups was statistically significant（P<0.05）. There was no significant difference of pulmonary function index between the two groups one week after operation（P>0.05）. After 3 months of operation， the percentage in the forced expiratory volume in 1-second percentage predicted （FEV1%）， and the percentage of forced expiratory volume in the expected value between the two groups were increased more diversely than those one week after operation， the ascending range in the observation group was lower than that in the control group， with significant difference（P<0.05）. The total incidence of complications in the observation group was lower than that in the control group， and the difference between the two groups was statistically significant （P<0.05）. After 12 months of follow-up，there were no significant differences in tumor metastasis and recurrence rates between the two groups（P>0.05）. Conclusion The use of thoracoscopic segmentectomy to treat early lung cancer can reduce the damage to the patient's lung function.

[Key words] Thoracoscopic lobectomy; Pulmonary segmentectomy; Early lung cancer; Lung function

肺癌有较高的临床发生率，同时也是死亡率增长最快的一类恶性肿瘤，危及广大群众的身体健康和生命安全[1]。目前临床上对于肺癌的具体致病原因尚未明确，早期肺癌主要以手术治疗为主[2]，以往主要以肺叶切除术治疗，但术中出血量大，容易损伤患者的肺功能[3]。随着临床医学的不断发展，胸腔镜肺段切除术具有创伤性小、并发症少、患者疼痛程度轻等优势，更有利于保护患者的肺功能。现选取2017年8月至2019年6月我院180例早期肺癌患者，旨在进一步对比胸腔镜肺叶切除术与肺段切除术的临床疗效，现报道如下。

1 资料与方法

1.1一般资料

选取2017年8月至2019年6月于我院接受手术治疗的180例早期肺癌患者，采用随机数字表法分为观察组和对照组，每组各90例。观察组男48例，女42例;年龄45～76岁，平均（60.18±2.33）岁;病变位置：右肺上叶32例，右肺下叶23例，左肺上叶20例，左肺下叶15例。对照组男46例，女44例;年龄46～78岁，平均（60.21±2.49）岁;病变位置：右肺上叶31例，右肺下叶24例，左肺上叶21例，左肺下叶14例。两组的一般资料比较，差异无统计学意义（P>0.05），具有可比性。

纳入标准：①经手术病理确诊为早期肺癌者[4];②均为周围型结节，且病灶直径均在2 cm以下者;③满足手术适应证，无禁忌证或过敏史者;④所有研究对象均在知情和自愿的前提下参与，均表示对本研究过程知情同意，且符合医院医学伦理要求。

排除标准[5]：①术前经影像学检查提示肺部结节直径>3 cm者;②合并肺部外伤、胸部外伤者;③合并凝血功能障碍者;④合并严重的肝肾、心脑等重要器官功能障碍者。