Objective To investigate the clinical effects of VATS lobectomy and VATS segmentectomy in the treatment of old age patients with non small cell lung cancer for stage Ⅰ.Methods 140 patients with non small cell lung cancer for stage Ⅰ were chosen and randomly divided into two group including group A(70 patients)with VATS lobectomy and group B(70 patients)with VATS segmentectomy;and the perioperative clinical indicators,level of lung function and CRP before and after operation and survival rate with follow-up of both groups were compared.Results The operation time,intraoperative blood loss amount,chest drainage volume and time and hospitalization staying time of group B[(118.15±33.61)min,(59.25±10.61)ml,(641.56±135.17)ml,(3.42±0.77)d and(5.08±1.32)d] were significantly better than group A[(135.33±40.10)min,(83.33±14.15)ml,(783.89±180.61)ml、(4.38±0.94)d和(6.52±1.58)d](P<0.05).There was no significant difference in the number of lymph node dissection between group A(12.67±2.64)and group B(12.38±2.58)(P<0.05).The levels of FVC and FEV1 after operation of group B was significantly higher than group A(P<0.05).The levels of CRP after operation of group B was significantly lower than group A(P<0.05).There was no significant difference in the 1 year survival rate with follow-up between group A(94.29%)and group B(94.29%)(P>0.05).Conclusion Compared with VATS lobectomy,VATS segmentectomy in the treatment of old age patients with non small cell lung cancer for stage Ⅰ can efficiently reduce surgical trauma degree,accelerate the recovery process of body,protect the lung ventilation function and be helpful to reduce the inflammatory response levels.%目的 探讨胸腔镜肺叶与肺段切除术治疗老年Ⅰ期非小细胞肺癌的临床疗效.方法 老年Ⅰ期非小细胞肺癌患者140例,以随机数字表法将140例患者分为A组(70例)和B组(70例),分别采用胸腔镜肺叶切除术和肺段切除术治疗,比较两组患者围手术期临床指标,手术前后肺功能指标和C-反应蛋白(CRP)水平,随访生存率.结果 B组患者手术时间、术中出血量、胸腔引流总量、胸腔引流时间及住院时间分别为(118.15±33.61)分钟、(59.25±10.61)ml、(641.56±135.17)ml、(3.42±0.77)天和(5.08±1.32)天,A组患者分别为(135.33±40.10)分钟、(83.33±14.15)ml、(783.89±180.61)ml、(4.38±0.94)天和(6.52±1.58)天,两组比较差异有统计学意义(P<0.05);A组和B组患者淋巴结清扫个数分别为(12.67±2.64)枚和(12.38±2.58)枚,差异无统计学意义(P>0.05);B组患者术后肺活量(FVC)与1秒钟用力呼吸容积(FEV1)水平均显著高于A组,差异有统计学意义(P<0.05);同时B组患者术后CRP水平均显著低于A组和术前,差异有统计学意义(P<0.05);B组患者1年生存率为94.29%,A组为c,两组比较差异无统计学意义(P>0.05).结论 与胸腔镜肺叶切除术比较,胸腔镜肺段切除术治疗老年Ⅰ期非小细胞肺癌可降低手术创伤程度,加快机体康复进程,保护肺部通气功能,并有助于减轻炎症反应水平.
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