全胸腔镜肺叶切除术治疗高龄非小细胞肺癌患者的近期疗效及远期预后影响因素分析

赵鑫　槐梅　张镱镭　丁磊

[摘要] 目的 研究分析全胸腔鏡肺叶切除术治疗高龄非小细胞肺癌患者的近期疗效及远期预后影响因素。方法 方便选取赤峰学院附属医院在2015年2月—2016年8月期间收治的122例高龄非小细胞肺癌患者作为研究对象并根据手术方式的不同随机分为观察组（61例）和对照组（61例），对照组患者给予传统的开胸肺叶切除术合淋巴结清扫术治疗，观察组患者给予全胸腔镜肺叶切除术合淋巴结清除术治疗，治疗后比较观察组与对照组患者的近期疗效及远期预后影响因素。结果 观察组患者术中出血量（139.53±43.21）mL及术后引流量（293.23±139.18）mL、手术时间（148.22±19.28）min及住院总时间（7.51±1.58）d、术后疼痛程度及不良反应发生率均明显低于对照组（P<0.05），观察组患者中位无瘤生存期和复发转移同对照组比较，差异无统计学意义（P>0.05）。结论 全胸腔镜肺叶切除术治疗高龄非小细胞肺癌患者的近期疗效值得肯定，且不同手术方式的远期疗效差异无统计学意义，其临床分期及组织分化情况是影响患者术后远期疗效的重要因素。

[关键词] 胸腔镜；肺叶切除术；非小细胞肺癌；近期疗效；影响因素

[中图分类号] R734.2 [文献标识码] A [文章编号] 1674-0742（2017）07（c）-0055-03

[Abstract] Objective To research and analyze the influence factors of short-term curative effect and long-term prognosis of complete video-assisted thoracic lobectomy in treatment of senile patients with non-small cell lung cancer. Methods 122 cases of senile patients with non-small cell lung cancer admitted and treated in Affiliated Hopital of Chifeng from February 2015 to August 2016 were convenient selected and randomly divided into two groups with 61 cases in each， the control group were treated with traditional pulmonary lobectomy and lymph node dissection， while the observation group were treated with complete video-assisted thoracic lobectomy and lymph node dissection， and the influence factors of short-term curative effect and long-term prognosis of complete video-assisted thoracic lobectomy in treatment of senile patients with non-small cell lung cancer of the two groups after treatment were analyzed. Results The intraoperative bleeding amount（139.53±43.21）mL， postoperative drainage amount （293.23±139.18）mL， operative time （148.22±19.28）min， total length of stay （7.51±1.58）d and postoperative pains degree and incidence rate of adverse reactions in the observation group were obviously lower than those in the control group（P<0.05）， and there were no obvious differences in the median non-tumor survival stage and recurrence and metastasis between the two groups（P>0.05）. Conclusion The short-term curative effect of complete video-assisted thoracic lobectomy in treatment of senile patients with non-small cell lung cancer is well received and there are no obvious differences in the long-term curative effects between different operative methods， and the clinical stages and tissue differentiation situation are the important influence factors of long-term curative effect after operation.

[Key words] Thoracoscope； Pulmonary lobectomy； Non-small cell lung cancer； Short-term curative effect； Influence factorendprint