电视胸腔镜与开胸手术对非小细胞肺癌的治疗效果对比及血清TGF-α CA21-1水平的变化

doi:10.3969/j.issn.1006-6233.2018.11.028

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摘要 目的: 观察电视胸腔镜与开胸手术对非小细胞肺癌的治疗效果对比及血清转化生长因子(TGF-α)、细胞角蛋白19片段(CA21-1)水平的变化。方法: 选取2016年2月至2017年2月我院接诊的80例患者作为本次研究对象。按照抽签法分为观察组40例和对照组40例。观察组采用电视胸腔镜肺叶切除手术,对照组采用常规开胸肺叶切除手术。观察两组患者手术时间、术中出血量、引流时间、淋巴结清扫数、住院时间手术指标,VAS评分,不良反应,治疗疗效。结果: 观察组术中出血量、引流时间、住院时间均显著小于对照组[(209.63±17.92)ml vs(321.42±19.36)ml,(4.80±1.20)d vs(6.97±1.72)d,(6.37±1.02)d vs(11.96±2.39)d](P<0.05);VAS评分显著低于对照组[(1.01±0.30)分 vs(2.34±0.52)分] (P<0.05); TGF-α、CA21-1水平显著低于对照组[(11.53±2.60)μg/L vs(20.69±3.86)μg/L,(3.18±0.52)μg/L vs(6.97±0.72)μg/L] (P<0.05);不良反应总发生率显著低于对照组[7.50%(3/40)vs42.86%(18/42)] (P<0.05)。结论: 对比电视胸腔镜与开胸手术治疗非小细胞肺癌研究发现,在电视胸腔镜辅助治疗下效果更为显著,能够减轻并发症及术后疼痛,调节免疫功能,降低血清TGF-α、CA21-1水平,有利于患者的预后,较常规开胸手术治疗更佳,能够达到满意的临床疗效。

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关键词 ：电视胸腔镜, 常规开胸, 肺叶切除手术, 非小细胞肺癌

Abstract：Objective: To study the effect of video-assisted thoracoscopy and thoracotomy on the treatment of non-small cell lung cancer and the changes of serum transforming growth factor (TGF- alpha) and cytokeratin 19 fragment (CA21-1). Methods:80 patients of hypertension with diabetes mellitus who received therapy from February 2016 to February 2017 in our hospital were selected as research objects. According to the According to ballot method divided into observation group(n=40) and control group(n=40). The observation group was treated with video-assisted thoracoscopic lobectomy,The control group was treated with conventional thoracotomy for lobectomy.Then the operation time, the amount of bleeding, the time of drainage, the clearance of lymph nodes, the operation indexes of the time of hospitalization, the VAS score, the adverse reaction, and the therapeutic effect in two groups were compared.Results:The intraoperative blood loss, drainage time and hospital stay in the observation group were significantly lower than those in the control group[(209.63±17.92)ml vs(321.42±19.36)ml,(4.80±1.20)d vs(6.97±1.72)d,(6.37±1.02)d vs(11.96±2.39)d](P<0.05);The VAS score was significantly lower than that of the control group [(1.01±0.30)score vs(2.34±0.52)score](P<0.05);The level of TGF- alpha and CA21-1 was significantly lower than that of the control group[(11.53±2.60)μg/L vs(20.69±3.86)μg/L,(3.18±0.52)μg/L vs(6.97±0.72)μg/L](P<0.05);The total incidence of adverse reactions was significantly lower than that of the control group [7.50% (3/40) vs42.86%(18/42)](P<0.05). Conclusions: Compared with video-assisted thoracoscopy and thoracotomy in the treatment of non-small cell lung cancer, video-assisted thoracoscopy is more effective.It can alleviate complications and postoperative pain, regulate immune function and reduce serum levels of TGF-alpha and CA21-1. It is beneficial to the prognosis of patients. It is better than conventional thoracotomy and can achieve satisfactory clinical efficacy.

Key words： Video-assisted thoracoscopy Routine thoracotomy lobectomy Non-small cell lung cancer

基金资助:湖北省科技计划项目,(编号:2011H0471)

通讯作者: 邓中彪

引用本文:

黄宏灵,邓中彪,黄进启,郑勇,任丹,涂啟敏. 电视胸腔镜与开胸手术对非小细胞肺癌的治疗效果对比及血清TGF-α CA21-1水平的变化[J]. 河北医学, 2018, 24(11): 1874-1877.
HUANG Hongling, DENG Zhongbiao, HUANG Jinqi, et al. The Effect of Video-assisted Thoracoscopy and Thoracotomy on the Treatment of Non-small Cell Lung Cancer and the Changes of Serum TGF-α CA21-1. HeBei Med, 2018, 24(11): 1874-1877.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.11.028 或 http://www.hbyxzzs.cn/CN/Y2018/V24/I11/1874

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