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目的:研究电视胸腔镜术在老年小结节非小细胞肺癌(Small nodules in non small cell lung cancer,sn NSCLC)患者治疗中的应用。方法:回顾2009年1月-2011年6月在我院接受电视胸腔镜术治疗的老年sn NSCLC88例患者的临床资料,按照手术方式将所有患者分为电视胸腔镜组与常规开胸组两个小组。电视胸腔镜组行电视胸腔镜术,常规开胸组行常规开胸术。观察两组患者手术指标、疼痛程度评分、手术前后1 d CRP、TNF-α、IL-6等炎性因子水平、术后并发症、1-3年生存率以及复发率等指标。结果:两组患者一般资料比较无统计学上的差异(P>0.05)。电视胸腔镜组术中出血量、术后引流时间、下床活动时间以及疼痛程度评分及术后1 d CRP、TNF-α、IL-6等炎性因子水平及术后并发症发病率均显著低于常规开胸组(P<0.05)。电视胸腔镜组术后1、2、3年生存率显著高于常规开胸组(P<0.05),且术后复发率显著低于常规开胸组(P<0.05)。结论:电视胸腔镜术治疗老年sn NSCLC创口小、恢复快,且有效避免过度激活炎性细胞,降低术后并发症发病率,值得应用于临床。
Objective: To study the application of video-assisted thoracoscopy in the treatment of elderly patients with small nodules in non-small cell lung cancer (NSCLC). Methods: The clinical data of 88 elderly patients with sn-NSCLC who underwent video-assisted thoracoscopic surgery in our hospital from January 2009 to June 2011 were retrospectively analyzed. All patients were divided into two groups according to the operation method: video thoracoscopy group and conventional thoracotomy group group. Video thoracostomy line thoracoscopy, conventional thoracotomy group routine thoracotomy. The indexes of operation, pain score, the levels of inflammatory cytokines such as CRP, TNF-α and IL-6 on 1 d before and after surgery were observed. The postoperative complications, 1-3 year survival rate and relapse rate were observed. Results: There was no statistical difference between the two groups (P> 0.05). The volume of postoperative drainage, postoperative drainage time, the time of going to bed, and the degree of pain in the video-assisted thoracoscopic group and the levels of inflammatory cytokines such as CRP, TNF-α, IL-6 and postoperative morbidity were significantly different Lower than the conventional thoracotomy group (P <0.05). The 1, 2 and 3-year survival rate of the video-assisted thoracoscopic group was significantly higher than that of the conventional thoracotomy group (P <0.05), and the recurrence rate was significantly lower than that of the conventional thoracotomy group (P <0.05). Conclusion: Video-assisted thoracoscopic surgery for the treatment of elderly patients with sn NSCLC is small and fast recovery, and can effectively avoid over-activation of inflammatory cells and reduce the incidence of postoperative complications, which is worthy of clinical application.