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《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:

期数:

2024年01期

页码:

95-98

栏目:

临床研究

出版日期:

2024-02-20

文章信息/Info

Title:

-

作者:

陆 祥; 陈卫荣

226100 江苏,南通市海门区人民医院胸外科

Author(s):

-

关键词:

肺磨玻璃结节;  单孔胸腔镜肺段切除术;  单孔胸腔镜肺楔形切除术;  并发症

Keywords:

-

分类号:

R563

DOI:

10.3877/cma.j.issn.1674-6902.2024.01.019

摘要:

目的 分析单孔胸腔镜肺段切除术与单孔胸腔镜肺楔形切除术在直径2 cm以下肺磨玻璃结节(grinding glass nodules, GGN)中的疗效及意义。方法 收集我院2018年6月至2022年6月间收治的69例行手术治疗的GGN患者为对象,分为观察组33例,行单孔胸腔镜肺楔形切除术; 对照组36例,行单孔胸腔镜肺段切除术。比较两组围术期相关指标、疼痛程度、肺功能、创伤应激指标、并发症及预后情况。结果 观察组术后平均手术时间(114.46±22.89)min、胸管留置时间(2.76±0.69)d及住院时间(4.41±0.88)d较对照组缩短,出血量(67.52±13.51)ml较对照组减少(P<0.05); 观察组淋巴结清扫数量(10.67±2.13)个,切缘距离(1.86±0.37)cm与对照组比较无统计学差异(P>0.05)。术后1 h、12 h、24 h,两组视觉模拟评分法(visual analogue scales, VAS)评分较术前逐渐下降,观察组术后1 h、12 h、24 h时VAS评分为(3.24±0.65)分、(2.46±0.49)分、(1.36±0.27)分低于对照组(P<0.05)。两组术后第一秒用力呼气容积(forced expiratory volume in the first second, FEV1)/用力肺活量(forced vital capacity, FVC)、呼气流量峰值(peak expiratory flow, PEF)水平下降,观察组FEV₁/FVC(77.15±4.06)%,PEF(1.59±0.32)L/s(P<0.05)。两组术后皮质醇(cortisol, Cor)、超敏C反应蛋白(hypersensitive, c-reactive protein, hs-CRP)、去甲肾上腺素(noradrenalin, NE)水平升高,观察组Cor(495.84±55.09)nmol/L、hs-CRP(8.65±1.73)mg/L、NE(287.29±31.92)μg/L(P<0.05)。观察组术后并发症2例(6.16%)对照组8例(22.22%)(P<0.05)。结论 单孔胸腔镜下肺段切除术与肺楔形切除术用于直径在2 cm以下GGN治疗中,疗效及预后好; 肺楔形切除术可缩短手术时间、减少出血及并发症,创伤小,肺功能影响小,有利于术后康复。

Abstract:

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备注/Memo

备注/Memo:

基金项目: 江苏省重点研发计划(BE2019643)
通信作者:陈卫荣, Email: chengwr66006@163.com

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更新日期/Last Update: 2024-02-20