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单孔和三孔胸腔镜手术对肺癌患者术后近期生活质量影响的比较研究

A prospective comparative study examing the impact of uniportal and three portal video-assisted thoracic surgery on short-term quality of life in lung cancer

摘要:

目的 比较单孔与三孔胸腔镜对肺癌患者术后短期生活质量的影响.方法 前瞻性收集中国科学技术大学附属第一医院胸外科2017年9月至11月行单孔胸腔镜或三孔胸腔镜肺癌根治术的120例患者的临床资料.男性64例,女性56例,年龄(62±10)岁(范围:28~ 82岁);单孔组60例,三孔组60例.采用独立样本t检验、x2检验、Fisher精确概率检验和Wilcoxon秩和检验比较两组的围手术期资料,采用重复测量方差分析比较术前及术后1、2、4、8周的生活质量.结果 两组患者临床病理特征差异无统计学意义(P>0.05).相较三孔组,单孔组术中出血量更少[(92±85) ml比(131±91)ml,t=2.387,P=0.019],术后置管时间[(4.4±3.1)d比(6.0±3.9)d,t=2.401,P=0.018]和术后住院时间[(6.2±4.0)d比(8.3±4.6)d,t=2.626,P=0.010]更短,两组并发症发生率、淋巴结清扫数目和站数差异无统计学意义(P>0.05).两组术前生活质量各维度无差异,社会功能、躯体功能、情感功能、角色功能和总体健康状况术后各时间节点单孔组的得分高于三孔组(P<0.05),疲劳和疼痛等得分低于三孔组(P<0.05).结论 单孔胸腔镜手术可达到三孔胸腔镜手术的安全性和根治性,在术中出血量、术后带管时间和术后住院时间方面及术后近期生活质量等方面具有优势.

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abstracts:

Objective To evaluate the effect of the postoperative short-term quality of life between uniportal and three portal video-assisted thoracic surgcry for radical lung canccr resection.Methods The perioperative data and short-term quality of life of 120 patients received uniportal and three portal videoassisted thoracic surgery for radical lung cancer resection were analyzed from September to November 2017 at Department of Thoracic Surgery,the First Affiliated Hospital of University of Science and Technology of China.There were 64 male and 56 female patients aging of (62±10) years (ranging from 28 to 82 years).There were 60 cases received uniportal (uniportal group) and 60 cases received three portal video-assisted thoracic surgery (three-portal group).Quality of life by measurement of functional and symptom scales was assessed before surgery at baseline,and 1,2,4,and 8 weeks after the operation.The t test,x2 test,Fisher exact test and Wilcoxon rank-sum test were used to compare the date between the 2 groups.Repeated measurement variance was used for comparison of the quality of life at different time points.Results There were no statistically significant differences in the clinicopathological features of the two groups (P>0.05).Intraoperative bleeding volume ((92± 85) ml vs.(131 ± 91) ml,t =2.387,P =0.019),postoperative catheter time ((4.4 ± 3.1) days vs.(6.0 ± 3.9) days,t =2.401,P =0.018),and postoperative hospitalization time ((6.2±4.0) days vs.(8.3±4.6) days,t =2.626,P=0.010) in the patients with uniportal group were less than that in three-portal group.Preoperative functional areas,symptom areas and overall health scores were similar in the two group.The functional areas such as physical function,role function,emotional function and social function and overall health status of uniportal group were significantly higher than those of three-portal group in postoperative time,while the fatigue and pain of uniportal group were significantly lower than that of three-portal group.Conclusions Uniportal video-assisted thoracic surgery can achieve the same safety and radical of three-portal video-assisted thoracic surgery.It has advantages in intraoperative bleeding volume,postoperative time after operation,hospitalization time and postoperative life quality.

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作者: 徐广文 [1] 熊燃 [1] 吴汉然 [1] 李彩伟 [1] 徐世斌 [1] 解明然 [1]
第一作者: 徐广文
作者单位: 中国科学技术大学附属第一医院胸外科,合肥,230001 [1]
期刊: 《中华外科杂志》2018年56卷6期 452-457页 MEDLINEISTICPKUCSCD
栏目名称: 论著
DOI: 10.3760/cma.j.issn.0529-5815.2018.06.013
发布时间: 2018-07-12
基金项目:
安徽省科学自然基金资助项目(1708085MH179)Natural Science Foundation of Anhui Province
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