| 王小卫,濮忠建,包军军,贾燕华.单孔、两孔及三孔胸腔镜下肺叶切除术对老年早期非小细胞肺癌的临床疗效及对氧化应激的影响[J].中国医药导报,2024,21(2):124-127 |
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| 单孔、两孔及三孔胸腔镜下肺叶切除术对老年早期非小细胞肺癌的临床疗效及对氧化应激的影响 |
| Clinical efficacy and influence of oxidative stress of single-, two-, and three-port thoracoscopic lobectomy in elderly patients with early-stage non-small cell lung cancer |
| 收稿日期：2023-03-31 |
| DOI：10.20047/j.issn1673-7210.2024.02.26 |
| 关键词: 非小细胞肺癌 老年 胸腔镜 氧化应激 |
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| 基金项目:江苏省南通市基础科学研究和社会民生科技计划项目（指导性）（MSZ2022070） |
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| 摘要:目的 研究单孔、两孔及三孔胸腔镜下肺叶切除术对老年早期非小细胞肺癌的临床疗效及对氧化应激的影响。 方法 将江苏省海安市中医院2019年7月至2022年7月收治的89例老年早期非小细胞肺癌患者纳入研究，通过随机数字表法将其分为单孔组（30例）、两孔组（30例）、三孔组（29例），分别在单孔、两孔、三孔胸腔镜下进行肺叶切除手术。记录比较三组围手术期指标，并于术后1 d通过视觉模拟评分法（VAS）评估三组疼痛程度，检测并比较三组术前及术后3个月肺功能[用力肺活量（FVC）、第1秒用力呼气容积（FEV1）]水平，检测比较三组术前及术后1 d氧化应激指标[肾上腺素（E）、去甲肾上腺素（NE）、皮质醇（Cor）]水平，记录三组并发症发生情况。 结果 三孔组手术时间长于单、两孔组，术后1 d VAS评分高于单孔、两孔组（P＜0.05）。术后3个月，三组FVC、FEV1均高于术前，三孔组FVC、FEV1均低于单孔组，FEV1低于两孔组（P＜0.05）。术后1 d，三组E、NE、Cor水平均高于术前，两孔、三孔组E、NE、Cor水平均高于单孔组，且三孔组高于两孔组（P＜0.05）。三孔组并发症发生率高于单孔组（P＜0.05）。 结论 单孔与两孔胸腔镜下肺叶切除术疗效相当，且单孔胸腔镜下行肺叶切除术能够有效减轻患者术后应激水平，且安全性较高。 |
| Abstract:Objective To investigate the clinical efficacy and influence of oxidative stress of single-, two-, and three-port thoracoscopic lobectomy in elderly patients with early-stage non-small cell lung cancer. Methods A total of 89 elderly patients with early-stage non-small cell lung cancer admitted to Haian Hospital of Traditional Chinese Medicine, Jiangsu Province from July 2019 to July 2022 were included in this study. They were divided into single-port group (30 cases), two-port group (30 cases), and three-port group (29 cases) by random number table method. Lobotomy was performed by single-, two-, and three-port thoracoscopy, respectively. Perioperative indexes of the three groups were recorded and compared, pain degree of the three groups was assessed by visual analogue scale (VAS) one day after surgery, and lung function levels (forced vital capacity [FVC] and forced expiratory volume in one second [FEV1]) of the three groups were detected and compared before and three months after surgery. The levels of oxidative stress indexes (epinephrine [E], nore- pinephrine [NE], and cortisol [Cor]) before and one day after operation were detected and compared among the three groups, and the occurrence of complications in the three groups were recorded. Results The operation time of the three-port group was longer than that of the single-port and two-port groups, and the VAS score on the first day after operation was higher than that of the single-port and two-port groups (P＜0.05). Three months after operation, FVC and FEV1 in the three groups were higher than those before operation, FVC and FEV1 in the three-port group were lower than those in the single-port group, and FEV1 was lower than that in the two-port group (P＜0.05). On the first day after surgery, the levels of E, NE, and Cor in the three groups were higher than before suregry, the levels of E, NE, and Cor in the two-port and three-port groups were higher than those in the single-port group, and those in the three-port group were higher than those in the two-port group (P＜0.05). The complication rate of the three-port group was higher than that of the single-port group (P＜0.05). Conclusion The efficacy of single-port thoracoscopic lobectomy is comparable to that of two-port thoracoscopic lobectomy, and single-port thoracoscopic lobectomy can effectively reduce the postoperative stress level of patients with high safety. |
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