目的 探讨单孔式与多孔式胸腔镜下肺叶切除术的临床应用效果,并阐述单孔式胸腔镜下肺叶切除术在临床治疗中的应用意义及价值。方法 选取2013年1月—2015年12月收治的298例行胸腔镜下肺叶切除术患者作为研究对象,根据其手术方式的不同分为单孔式胸腔镜下肺叶切除术(单孔组)148例,多孔式胸腔镜下肺叶切除术(多孔组)150例,比较两组手术效果。结果 单孔组术中出血量、术后盐酸哌替啶用量、住院时间均明显少于多孔组(P<0.01),两组手术时间、淋巴结清扫数目、并发症发生率比较差异无统计学意义(P>0.05);单孔组术后第3天、第7天的VAS评分均明显低于同时点多孔组(P<0.01);两组术前生活质量各项指标比较差异无统计学意义(P>0.05);单孔组术后3个月功能状态、情感状态评分及总评分均显著高于多孔组(P<0.01)。结论 与多孔式胸腔镜下肺叶切除术相比,单孔式胸腔镜下肺叶切除术能有效减少手术创伤,促进术后机体恢复,同时提高患者的短期生活质量。
Objective To investigate the clinical effects of single-incision and multiple-incision thoracoscopic lobectomy, and illustrate the significance and value of single-incision thoracoscopic lobectomy in clinical application.Methods A total of 298 patients with thoracoscopic lobectomy were selected from January 2013 to December 2015 and divided into single-incision (n=148) and multiple-incision (n=150) thoracoscopic lobectomy groups according to the operation methods they received.The operative effects between the two groups were compared.Results The amount of blood loss, dosage of hydrochloric acid, and length of hospital stay of the single-incision thoracoscopic lobectomy group were significantly less than those of the multiple-incision thoracoscopic lobectomy group (P<0.01). There were no differences in operation time, number of lymph node removed, and complication rate between the two groups (P>0.05). The VAS scores on the 3rd and 7th days of the single-incision thoracoscopic lobectomy group were all significantly lower than those of the multiple-incision thoracoscopic lobectomy group at the same time points (P<0.01). No statistical differences in the indicators related to quality of life were found between the two groups before operation (P>0.05). The function, emotion, and total scores of the single-incision thoracoscopic lobectomy group were significantly higher than those of the multiple-incision thoracoscopic lobectomy group after 3 months of operation (P<0.01).Conclusion Compared with multiple-incision thoracoscopic lobectomy, single-incision thoracoscopic lobectomy can effectively reduce surgical trauma, promote postoperative recovery, and improve the short-term quality of life of patients.
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