单孔胸腔镜下肺段切除术治疗非小细胞肺癌的疗效观察

目的:观察单孔胸腔镜下肺段切除术对非小细胞肺癌患者的治疗效果，分析其对患者术后疼痛、并发症发生率及生存率的影响。方法:选取本院2014年1月至2015年9月收治的非小细胞肺癌患者87例为研究对象，按照随机数表法分为单孔组45例和三孔组42例，单孔组采用单孔胸腔镜下肺段切除术治疗，三孔组采用常规三孔胸腔镜下肺段切除术治疗。采用视觉模拟评分法（visual analogue scale，VAS）对患者术后疼痛程度进行评分。结果:两组患者术中纵隔淋巴结切除个数无显著差异（P＞0.05），单孔组患者手术时间显著高于三孔组（P＜0.05），术中出血量、术后胸腔引流量、住院天数及术后并发症发生率显著低于三孔组（P＜0.05）。两组患者术后1 d、3 d、7 d疼痛评分均呈逐渐降低趋势（P＜0.05），且单孔组显著低于三孔组（P＜0.05）。单孔组无进展生存率与三孔组之间无显著差异（P＞0.05）。结论:单孔胸腔镜下肺段切除术对非小细胞肺癌患者疗效显著，可抑制患者术后疼痛，降低并发症发生率，且3年内生存率与三孔法相当。

Observation of curative effect of single-hole thoracoscopic segmentectomy for non-small cell lung cancer

Objective:To study the therapeutic effect of single-hole thoracoscopic segmentectomy for non-small cell lung cancer(NSCLC),and to analyze its influences on postoperative pain,incidence of complications and survival rate.Methods:87 patients with non-small cell lung cancer admitted to our hospital from January 2014 to September 2015 were selected as the study subjects,according to the random number table.They were divided into 45 patients in single-hole group and 42 patients in three-hole group.Single-hole group was treated with single-hole thoracoscopic segmentectomy,while three-hole group was treated with conventional three-hole thoracoscopic segmentectomy.Visual analogue scale(VAS) was used to evaluate the degree of pain after operation.Results:There was no significant difference in the resected number of mediastinal lymph node between the two groups(P＞0.05).The operation time of the single-hole group was significantly higher than that of the three-hole group(P＜0.05).The intraoperative blood loss,postoperative thoracic drainage,hospitalization days,and the incidence of complications were significantly lower than those of the three-hole group(P＜0.05).The pain score of the two groups decreased gradually on the 1st,3rd,and 7th day after operation(P＜0.05),and the single-hole group was significantly lower than the three-hole group(P＜0.05).There was no significant difference in progression-free survival rate between single-hole group with three-hole group(P＞0.05).Conclusion:Single-hole thoracoscopic segmentectomy is effective for patients with non-small cell lung cancer.It can inhibit postoperative pain,reduce the incidence of complications,and the 3-year survival rate is similar to that of three-hole thoracoscopic segmentectomy.