目的：探讨胸腔镜在非小细胞肺癌高龄患者肺叶切除术中的应用价值。方法将86例高龄早期非小细胞肺癌患者分为开胸组与胸腔镜组，2组分别行开胸肺叶切除术及胸腔镜下肺叶切除术。比较2组1年无瘤生存率、手术效果、术后炎症因子及免疫学指标的改变。结果胸腔镜组与开胸组在手术时间、术中出血量、淋巴结清扫数目及术后并发症发生率方面差异均无统计学意义（P＞0．05）。胸腔镜组1年无瘤生存率为97．5％，开胸组为97．8％（P＞0．05）。与开胸组相比，胸腔镜组术后7 d血清超敏C-反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF-α）及白细胞介素-6（IL-6）显著降低（P＜0．05），而IgG及IgM水平显著升高（P＜0．05）。结论胸腔镜肺叶切除术治疗高龄非小细胞肺癌的近期疗效与开胸手术相当，但前者机体炎症反应轻、免疫功能恢复快。%Objective To explore the application value of thoracoscopy in pulmonary lobectomy for elderly non -small cell lung cancer patients .Methods 86 elderly patients with non-small cell lung cancer were divided into the open chest group and the thoracoscopic group ,and the 2 groups received pulmonary lobectomy and thoracoscopic pulmonary lobectomy ,respective-ly.1-year disease-free survival,operation effect,serum inflammatory factors and immunological indexes were compared between the 2 groups .Results Operation time ,intraoperative blood loss ,the number of lymph nodes dissection and complications between the 2 groups had no significant difference (P>0.05);1-year disease-free survival in the thoracoscopic group and the open chest group were 97.5%and 97.8%(P>0.05);Compared with the open chest group ,hs-CRP,TNF-αand IL-6 greatly decreased, while IgM and IgG increased in the thoracoscopic group 7 days after operation (P>0.05).Conclusion Thoracoscopic and open chest pulmonary lobectomy have equivalent effects for elderly non-small cell lung cancer patients ,while the thoracoscopy operation has less inflammatory reactions and fast recovery of immune function .
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