摘要
目的:探究CT引导下Hook-wire定位配合胸腔镜手术在早期肺癌患者中的应用价值。方法:选取2018年1月至2021年1月就诊的早期肺癌患者60例,按照随机数字表法分组,各30例。对照组采取常规胸腔镜手术,研究组采取CT引导下Hook-wire定位配合胸腔镜手术。比较两组手术情况、切缘阳性率、创伤应激指标[白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、皮质醇(Cor)、C反应蛋白(CRP)]、心肺功能[每搏量(SV)、左心室射血分数(LVEF)、用力肺活量(FVC)、每分钟最大通气量(MVV)]、肿瘤相关生长因子[血管内皮生长因子-C(VEGF-C)、肿瘤特异性生长因子(TSGF)、表皮生长因子受体(EGFR)]水平、肺癌患者生存质量测定量表(FACT-L)及并发症发生率。结果:与对照组(161.55±40.31)mL、(157.22±35.21)min、(4.53±1.26)d、(15.27±4.02)d、(6.90±0.46)个相比,研究组术中出血量(108.67±26.83)mL较少,手术时间(136.43±30.19)min、胸腔引流时间(2.82±0.90)d、住院时间(11.34±2.58)d较短,淋巴结清扫数目(7.45±0.50)个较多(P<0.05);两组切缘阳性率无统计学意义(P>0.05);与对照组相比,研究组术后1d、3d、5d血清IL-6、IL-8、Cor、CRP较低(P<0.05);两组术后1周、1个月SV、LVEF、FVC、MVV高于术前,且与对照组相比,研究组较高,血清VEGF-C、TSGF、EGFR低于术前,且与对照组相比,研究组较低(P<0.05);两组术后3个月FACT-L量表生理状况、社会/家庭状况、与医生关系、情感状况、功能状况、附加的关注情况评分高于术前,且与对照组相比,研究组较高(P<0.05);与对照组26.67%(8/30)相比,研究组并发症发生率6.67%(2/30)较低(P<0.05)。结论:CT引导下Hook-wire定位配合胸腔镜手术治疗早期肺癌患者可显著优化手术情况,抑制肿瘤生长,避免切缘阳性,促进心肺功能恢复,减少并发症,提高生存质量。
Objective:To explore the application value of CT-guided Hook-wire localization combined with thoracoscopic surgery in patients with early stage lung cancer.Methods:60 patients with early-stage lung cancer from January 2018 to January 2021 were selected and grouped according to the random number table method,with 30 patients in each group.The control group was treated with conventional thoracoscopic surgery,and the study group was treated with CT guided hook wire positioning combined with thoracoscopic surgery.The surgical conditions,positive rate of incision margin,trauma stress indexes[interleukin-6(IL-6),interleukin-8(IL-8),cortisol(COR),C-reactive protein(CRP)],cardiopulmonary function[stroke volume(SV),left ventricular ejection fraction(LVEF),forced vital capacity(FVC),maximum ventilation volume per minute(MVV)]were compared between the two groups The levels of tumor related growth factors[vascular endothelial growth factor-C(VEGF-C),tumor specific growth factor(TSGF),epidermal growth factor receptor(EGFR)],the quality of life scale for lung cancer patients(FACT-L)and the incidence of complications.Results:Compared with the control group(161.55±40.31)ml,(157.22±35.21)min,(4.53±1.26)d,(15.27±4.02)d,(6.90±0.46),the study group had less intraoperative bleeding(108.67±26.83)ml,operation time(136.43±30.19)min,thoracic drainage time(2.82±0.90)d,hospital stay(11.34±2.58)d,and more lymph node dissections(7.45±0.50)(P<0.05).There was no significant difference in the positive rate of cutting edge between the two groups(P>0.05);Compared with the control group,the levels of serum IL-6,IL-8,cor and CRP in the study group were lower on the 1st,3rd and 5th day after operation(P<0.05);SV,LVEF,FVC and MVV in the two groups 1 week and 1 month after operation were higher than those before operation,and compared with the control group,the study group was higher,the serum VEGF-C,TSGF and EGFR were lower than those before operation,and compared with the control group,the study group was lower(P<0.05);Three months after operation,the scores of physiological status,social/family status,relationship with doctors,emotional status,functional status and additional attention of the two groups were higher than those before operation,and the study group was higher than that of the control group(P<0.05);Compared with 26.67%(8/30)of the control group,the incidence of complications in the study group was 6.67%(2/30)(P<0.05).Conclusion:CT guided hook wire positioning combined with thoracoscopic surgery in the treatment of patients with early lung cancer can significantly optimize the operation,inhibit tumor growth,avoid positive margin,promote the recovery of cardiopulmonary function,reduce complications and improve the quality of life.
作者
孔劲松
KONG Jinsong(The First People's Hospital of Suzhou, Anhui Suzhou 234000, China)
出处
《河北医学》
CAS
2022年第5期823-829,共7页
Hebei Medicine
基金
安徽省卫生厅医药科研计划项目,(编号:12925KJ2017B29)。
