胸腔镜肺癌根治术与传统开胸手术治疗非小细胞癌患者的临床观察

Clinical Observation of Thoracoscopic Radical Resection for Lung Cancer and Traditional Thoracotomy in the Treatment of Patients with Non-Small Cell Lung Cancer

摘要: 目的：讨论胸腔镜下肺癌根治性肺叶切除术与传统肺癌根治开胸手术对患者的术前、术后相关指标及医院焦虑抑郁量表(HADS)评分的影响。方法：随机选择2023年1月~2025年3月于安徽医科大学附属第二医院行胸腔镜肺叶切除术治疗的非小细胞肺癌患者30例(胸腔镜组包含单孔胸腔镜、双孔胸腔镜)，同时随机选择2023年1月~2025年3月本院行传统开放肺叶切除术治疗的非小细胞肺癌患者30例(传统开胸组)。比较2组手术的手术时间、淋巴结清扫数量、术中出血量、术后3天引流量、术后拔管时间、住院时间、术后疼痛及医院焦虑抑郁量表(HADS)评分。结果：俩组相比胸腔镜组手术时间减少(P < 0.05)。胸腔镜组的淋巴结清扫数量与传统开胸手术组相比没有明显的变化(P > 0.05)；胸腔镜组的术中出血量相对减少(P < 0.05)；胸腔镜组术后第3天的胸管引流量也有所降低(P < 0.05)，拔管时间较为缩短(P < 0.05)，住院时间较为减少(P < 0.05)；胸腔镜组术后第5天的疼痛程度有所减轻(P < 0.05)；胸腔镜组的医院焦虑抑郁量表(HADS)总分较低，差异具有统计学意义(P < 0.05)。综上所述，胸腔镜下肺叶切除术在手术时间、淋巴结清扫、术中出血量、术后引流量、拔管时间、住院时间、伤口疼痛及心理创伤方面存在一定的优势。

Abstract: Objective: To discuss the effects of thoracoscopic radical lobectomy and traditional radical thoracotomy on preoperative and postoperative related indicators and hospital anxiety and depression scale (HADS) scores. Methods: A total of 30 patients with non-small cell lung cancer treated with thoracoscopic lobectomy in the Second Affiliated Hospital of Anhui Medical University from January 2023 ~ March 2025 (the thoracoscopy group includes single-port thoracoscopy and double-port thoracoscopy) were randomly selected, and 30 patients with non-small cell lung cancer treated by traditional open lobectomy in our hospital from January 2023 ~ March 2025 (traditional thoracotomy group) were randomly selected. Comparative indicators included: duration of surgery, amount of intraoperative blood loss, number of lymph nodes cleaned, 3 days of postoperative drainage, time to drain tube, length of hospital stay, postoperative pain, and anxiety and depression test score (HADS). Results: The operation time of the thoracoscopic group was shorter than that of the traditional thoracotomy group (P < 0.05). There was no significant difference in the number of lymph nodes dissected between the two groups (P > 0.05). The intraoperative blood loss in the thoracoscopic group was relatively less (P < 0.05). The thoracic drainage volume on the third day after operation and the extubation time in the thoracoscopic group were also reduced (P < 0.05), and the hospital stay was shorter (P < 0.05). The pain degree on the fifth day after operation in the thoracoscopic group was alleviated (P < 0.05). The total score of the Hospital Anxiety and Depression Scale (HADS) in the thoracoscopic group was lower, and the difference was statistically significant (P < 0.05). In conclusion, thoracoscopic lobectomy has certain advantages in operation time, lymph node dissection, intraoperative blood loss, postoperative drainage volume, extubation time, hospital stay, wound pain and psychological trauma.