目的 探讨胸腔镜下肺癌根治术患者临床效果及免疫、炎性反应状态.方法 选取2009年5月至2011年9月于本院进行治疗的70例肺癌患者为研究对象,将其随机分为对照组(开胸根治术组)和观察组(胸腔镜下根治术组)各35例,比较两组患者出血量、留置引流管时间、下床活动时间、住院时间、并发症发生率及术前、术后3d、术后7d的红细胞免疫指标、外周血T淋巴细胞亚群和血清CRP、IL-6、TNF-α、IL-10水平.结果 观察组出血量少于对照组,留置引流管时间、住下床活动时间、住院时间均短于对照组,并发症发生率低于对照组,手术前后红细胞免疫指标、外周血T淋巴细胞亚群及血清CRP、IL-6、TNF-α、IL-10水平的波动幅度均小于对照组,P均＜0.05,差异有统计学意义.结论 胸腔镜下肺癌根治术不仅具有较好的临床效果,且对患者的免疫及炎性反应状态影响也更小.%Objective To study the clinical effect, immune state and inflammatory state of video-assisted thoracoscopic surgery in radical operation for patients with lung cancer. Methods Seventy patients with lung cancer in our hospital from May 2009 to September 2011 were selected as research objects. The patients were randomly divided into two groups: the control group (treated by thoracotomy resection) and the observation group (treated by thoracoscopic resection), with 35 cases in each group. Then the blood loss, time of indwelling drainage tube, out-of-bed activity, length of hospital stay, incidence of complications, as well as the RBC immune indexes, peripheral blood T lymphocyte subsets, and serum levels of CRP, IL-6, TNF-α, IL-10 before surgery, 3 days and 7 days after surgery were compared between the two groups. Results The blood loss of the observation group was significantly less than that of the control group, and time of indwelling drainage tube, out-of-bed activity, length of hospital stay were significantly shorter than those of the control group. The fluctuation range of RBC immune indexes, peripheral blood T lymphocyte subsets, serum levels of CRP, IL-6, TNF-α, IL-10 before surgery and after surgery were all significantly smaller in the observation group than those in the control group, all P<0.05. Conclusion For treating patients with lung cancer, the video-assisted thoracoscopic surgery in radical operation not only has better clinical effect, but exerts smaller influence on the immune state and inflammatory state.
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