摘要
目的比较完全胸腔镜与传统开放手术治疗非小细胞肺癌(NSCLC)的感染率差异及相关因素。方法收集2010年6月-2011年6月胸外科手术治疗的NSCLC患者32例实施完全胸腔镜手术(试验组),同期33例NSCLC患者行传统开放手术作为对照组。结果对照组肺部感染1例,肺不张1例,心律不齐1例,切口感染1例,肩部活动障碍1例,术后并发症发生率为15.1%,其中术后感染的发生率为6.1%;试验组肩部活动障碍1例,术后并发症总体发生率为3.1%,其中感染发生率为0,两组术后感染发生率差异有统计学意义(P<0.01);治疗后30d与治疗前和术后5d比较,差异均有统计学意义(均P<0.05),试验组中VEGF减少更为显著(P<0.05);两组术后5dIL-6居于较高水平(P<0.05),术后30d降低显著,与对照组比,试验组降低幅度更大;试验组术中出血量比对照组少(P<0.05);试验组术后住院天数比对照组短(P<0.05);两组手术时间、术后引流天数、引流量差异均无统计学意义;两组VEGF术前和术后5d比较,差异均无统计学意义。结论术后免疫力差异导致两组感染发生率不同,完全胸腔镜较传统开放手术对患者手术创伤小、感染发生率低,可以改善患者的预后,是安全可靠的手术,值得临床推广。
OBJECTIVE To compare the differences in infection rates between totally video-assisted thoracoscopic surgery and traditional open surgery during the treatment of non-small cell lung cancer（NSCLC） and investigate relevant factors.METHODS From Jun.2010 to Jun.2011 in our hospital,we compared the treatment of thoracic surgery for 32 patients with NSCLC underwent fully-assisted thoracic surgery and 33 NSCLC patients underwent traditional open surgery.RESULTS In the control group,there was 1 case of lung infection,1 case of atelectasis,1 case of arrhythmia,1 case of wound infection,and 1 case of shoulder movement disorder.The incidence of postoperative complications was 15.1% and the postoperative infection rate was 6.1%.In the test group,there was 1 case of shoulder movement disorder.The total incidence of postoperative complications was 3.1%.The incidence of infection was 0.The difference in the incidence of postoperative infections between the two groups was statistically significant（P〈0.01）.Thirty days after operation,VEGF in two groups significantly decreased compared with that before treatment and 5 days after operation（P〈0.05） and decreased more significantly in totally video-assisted thoracoscopic surgery group（P〈0.05）.Five days after operation,IL-6 increased to a higher level（P〈0.05） in both groups,and significantly decreased 30 days after operation.Compared with the control group,the level in the test group decreased more sharply（P〈0.05）.the blood loss in the test group was less than the control group（P〈0.05）;and hospitalization duration of the test group was shorter than the control group（P〈0.05）.Operative time,postoperative drainage days and drainage volume were not statistically different between the two groups;there was no significant difference in VEGF between the two groups before and 5 days after treatment.CONCLUSION The difference of immunity after surgery leads to different infection incidences inthe two groups.Compared with traditional open surgery,the totally video-assisted thoracoscopic surgery has less surgical trauma and lower infection rate and can improve the prognosis of patients.It is a safe and reliable operation and should be used widely.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2012年第4期721-723,共3页
Chinese Journal of Nosocomiology
关键词
完全胸腔镜手术
传统开放手术
非小细胞肺癌
Totally video-assisted thoracoscopic surgery
Traditional open surgery
Non-small cell lung cancer
