摘要
目的探讨FTS对胸腔镜下早期非小细胞肺癌根治术患者的围术期及血清学指标的变化影响和预后相关性研究。方法 90例早期非小细胞肺癌患者,采用完全随机分组法分为对照组和治疗组。对照组患者给予单纯胸腔镜下手术治疗,而治疗组则采用胸腔镜下快速康复外科流程的治疗模式,比较两组患者围术期相关指标等情况差异。结果两组手术时间比较无统计学差异(P> 0. 05),但治疗组术后下床活动时间、术后首次进食时间、胸腔引流管留置时间、术后住院时间均较对照组缩短(P <0. 05),且住院费用、术后镇痛药用量及术后并发症发生率均低于对照组(P <0. 05);治疗后,治疗组的肺功能各项指标水平均较对照组改善明显,且治疗组术后VAS评分显著低于对照组(P <0. 05);治疗前,两组血清学指标比较均无统计学差异(P> 0. 05);治疗后,两组血清IGF-1R浓度均有所下降,其中治疗组下降程度显著高于对照组(P <0. 05),而两组血清IFN-γ水平则有所升高,且治疗组升高程度显著高于对照组(P <0. 05);经Spearman相关分析,治疗组患者治疗后血清IGF-1R水平与相应患者复发或转移情况呈正相关(γ=0. 774,P <0. 05),而血清S100A2水平则呈负相关(γ=-0. 838,P <0. 05)。结论在胸腔镜下将快速康复外科流程应用于肺癌手术中,能有效加快患者康复、提高患者预后,同时血清学指标可用于其预后的判断,值得临床大力推广。
Objective To explore clinical Study of perioperative and serum indexex variation and prognostic relevance in the application of FTS in treatment of Stage I-II non-small cell lung cancer. Methods 90 cases of patients with Stage Ⅰ ~ ⅡNon-small Cell Lung Cancer admitted to our hospital,then were randomly divided into study group and control group,the control group was treated with Thoracoscop,while the study group was treated through the application of fast-track surgery principles,The perioperative and serum indicators and prognostic relevance were observed and compared between two groups. Results There was no significantly difference in operation time between the two groups( P > 0. 05),but compared with control group,the first time for taking food,postoperative hospital stay,chest tube indwelling time and the other indexes were significantly reduced in study group( P < 0. 05). After treatment,the levels of pulmonary fuction indexes in study group were better than those of control group,with statistical differences( P < 0. 05) and the VAS scores in study group were lower than those of control group( P < 0. 05);The levels of serum IGF-1 R of two groups decreased,but the levels in study group were lower than those of control group( P < 0. 05),and the levels of serum S100 A2 of two groups increased,but the levels in study group were higher than those of control group( P< 0. 05);After treatment,the prognosis were correlated positively with serum IGF-1 R levels in study group( P < 0. 05),and correlated negatively with serum S100 A2 levels in study group( P < 0. 05). Conclusion The minimally invasive surgery with FTS can speed up the recovery,improve the prognosis,at the same time,the serum indexes can be available for judging the prognosis,thus should be widely applied.
作者
王涛
辛向兵
韩勇
WANG Tao;XIN Xiangbing;HAN Yong(Tangdu Hospital,Air Force Medical University,Xi'an,710038)
出处
《实用癌症杂志》
2019年第3期411-414,共4页
The Practical Journal of Cancer
作者简介
通讯作者:韩勇.
