单操作孔与传统多孔胸腔镜肺结节切除术治疗老年孤立肺结节的疗效比较

doi:10.3969/j.issn.1006-6233.2019.12.015

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1258 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的:比较单操作孔与传统多操作孔胸腔镜肺结节切除术治疗老年孤立肺结节(SPN)的疗效。方法:选取本院100例老年SPN患者,均行肺结节切除术,按照简单随机分组方法,分为对照组采取常规多孔胸腔镜手术,观察组采取单操作孔胸腔镜手术,两组各50例。比较两组手术相关指标、手术前后肺功能指标变化、术后疼痛评分和并发症的发生情况等差异。结果:相比对照组,观察组术中出血量和术后引流量明显减少,术后住院天数和引流时间明显缩短(P<0.05);两组患者手术时间的比较,并无明显差异(P>0.05)。相比对照组,观察组术后肺活量(FVC)、最大通气量(MVV)和第1秒用力呼气容积(FEV1)明显改善(P<0.05)。观察组术后24、72h视觉模拟评分(VAS)较对照组明显减少(P<0.05)。两组患者术后肺部感染和肺不张等并发症发生率比较,并无统计学意义(P>0.05)。结论:相比常规多孔胸腔镜,单操作孔胸腔镜肺结节切除术可有效提升老年SPN患者的治疗效果,改善患者肺功能状况,有助于促进术后康复,提高生活质量,因此具有良好的临床应用价值。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	陆荣国
	郑明峰

关键词 ：肺结节切除术, 单操作孔胸腔镜, 孤立肺结节, 老年, 肺功能

Abstract：Objective: To compare the efficacy of single-port and traditional multi-hole thoracoscopic pulmonary nodulectomy in the treatment of solitary pulmonary nodules (SPN) in the elderly. Methods: 100 elderly patients with SPN underwent pulmonary nodule resection in our hospital were selected. According to the simple random group method, they were divided into the control group with conventional multi-hole thoracoscopic surgery, the observation group with single-port thoracoscopic surgery, 50 cases in each group. The changes of surgical indicators, lung function indicators before and after surgery, postoperative pain score and complications were compared between the two groups. Results: Compared with the control group, intraoperative blood loss and postoperative drainage volume were significantly reduced in the observation group, and postoperative hospital stay and drainage time were significantly shortened (P<0.05). There was no significant difference in operation time between the two groups (P>0.05). Compared with the control group, postoperative forced vital capacity (FVC), maximal voluntary ventilation (MVV) and forced expiratory volume in one second (FEV1) in the observation group were significantly improved (P<0.05). Visual analogue scale (VAS) was significantly reduced in the observation group 24 and 72 hours after surgery compared with the control group (P<0.05). There was no statistically significant difference in the incidence of postoperative complications such as pulmonary infection and atelectasis between the two groups (P>0.05). Conclusion: Compared with conventional multi-hole thoracoscopy, single-port thoracoscopic pulmonary nodule resection can effectively improve the treatment effect of elderly patients with SPN, improve the pulmonary function of patients, contribute to promote postoperative rehabilitation and improve the quality of life, so it has good clinical application value.

Key words： Pulmonary nodule resection Single-port thoracoscopy Solitary pulmonary nodule Elderly Lung function

基金资助:江苏省自然科学基金项目,(编号:BK20160936)

通讯作者: 郑明峰

引用本文:

陆荣国, 郑明峰. 单操作孔与传统多孔胸腔镜肺结节切除术治疗老年孤立肺结节的疗效比较[J]. 河北医学, 2019, 25(12): 1989-1993.
LU Rongguo, ZHENG Mingfeng. Comparison of the Efficacy of Single-port and Traditional Multi-hole Thoracoscopic Pulmonary Nodulectomy in the treatment of Solitary Pulmonary Nodules in the Elderly. HeBei Med, 2019, 25(12): 1989-1993.

链接本文:

http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2019.12.015 或 http://www.hbyxzzs.cn/CN/Y2019/V25/I12/1989

[1] Chan EY, Gaur P, Ge Y, et al. Management of the solitary pulmonary nodule[J].Arch PatholLab Med,2017,141(7):927~931.
[2] 谢冬,陈昶,朱余明,等.单孔胸腔镜手术的现状与展望[J].中华腔镜外科杂志:电子版,2016,9(2):73~76.
[3] Heller GZ, Manuguerra M, Chow R.How to analyze the visual analogue scale: myths, truths and clinical relevance[J].Scand Pain,2016,13(1):67~75.
[4] 王越,宋龙霞,黄艳,等.孤立性肺结节55例的影像学特征分析[J].中国基层医药,2018,25(3):352~355.
[5] Chen JR, Tseng YH, Lin MW, et al. Safety and efficacy of computed tomography-guided dye localization using patent blue V for single lung nodule for video-assisted thoracoscopic surgery: a retrospective study[J].Ann Transl Med,2019,7(2):28.
[6] 洪英财,陈怀生,林少霖,等.电视胸腔镜单操作孔方法行肺大疱切除术治疗气胸临床分析[J].河北医学,2015,21(10):1585~1588.
[7] Donahoe LL,Nguyen ET,Chung TB,et al. CT-guidedmicrocoil VATS resection of lung nodules: a single-centre experience and review of the literature[J].Thorac Dis,2016,8(8):1986~1994.
[8] Lin MW,Tseng YH,Lee YF,et al. Computed tomographyguided patent blue vital dye localization of pulmonary nodules in uniportalthoracoscopy[J].ThoracCardiovasc Surg,2016,152(2):535~544.
[9] Madariaga MLL, Lanuti M.Sampling of suspicious solitary pulmonary nodules: electromagnetic navigational bronchoscopy and video-assisted thoracoscopic surgery[J].Semin Roentgenol,2017,52(3):178~184.
[10] Lempel JK, Raymond DP, Ahmad U, et al. Video-assisted thoracic surgery resection without intraoperative fluoroscopy after CT-guided microcoillocalization of peripheral pulmonary nodules[J].VascInterv Radiol,2018,29(10):1423~1428.
[11] Huang HZ, Wang GZ, Xu LC, et al. CT-guided Hookwire localization before video-assisted thoracoscopic surgery for solitary ground-glass opacity dominant pulmonary nodules: radiologic-pathologic analysis[J].Oncotarget, 2017,8(64):108118~108129.