单孔与三孔胸腔镜肺癌根治术对患者T淋巴细胞亚群、应激反应及生活质量的影响

目的:探讨单孔与三孔胸腔镜肺癌根治术对患者T淋巴细胞亚群、应激反应及生活质量的影响。方法:选择2016年2月～2018年9月期间我院收治的肺癌根治术患者127例为研究对象,依据随机数字表法将其分成单孔组(n=63,采用单孔胸腔镜肺癌根治术治疗)和三孔组(n=64,采用三孔胸腔镜肺癌根治术治疗),比较两组患者手术及临床指标、T淋巴细胞亚群、应激反应指标及生活质量评分,并观察两组患者术后并发症发生情况。结果:单孔组术中出血量少于三孔组,住院时间短于三孔组,而手术时间长于三孔组(P0.05),而两组淋巴结清扫个数、术后引流时间、术后引流量比较差异无统计学意义(P0.05)。术后1d、术后7d单孔组皮质醇、生长激素、PGE_2均低于三孔组(P0.05)。术后3d单孔组CD3~+、CD4~+以及CD4~+/CD8~+高于三孔组(P0.05)。术后3个月单孔组躯体疼痛、社会功能、情感职能、平均分数高于三孔组(P0.05)。两组患者术后并发症总发生率比较无差异(P0.05)。结论:与三孔胸腔镜肺癌根治术相比,单孔胸腔镜肺癌根治术可减少患者术中出血量,缩短住院时间,减轻机体应激反应,对免疫功能损害较轻,且可有效改善患者生活质量。

Effects of Single-port and Three-port Thoracoscopic Radical Resection of Lung Cancer on T Lymphocyte Subsets, Stress Response and Quality of Life in Patients

ABSTRACT Objective: To investigate the effects of single-port and three-port thoracoscopic radical resection of lung cancer on T lymphocyte subsets, stress response and quality of life. Methods: 127 cases of radical resection of lung cancer who were received in our hospital from February 2016 to September 2018 were selected as subjects of study. They were divided into single-port group (n=63, treated by single-port thoracoscopic radical lung cancer) and three-port group (n=64, treated by three-port thoracoscopic radical lung cancer) according to the random number table method. The operative and clinical indexes, T lymphocyte subsets, stress response indexes and quality of life scores were compared between the two groups, and the occurrence of complications after operation was observed. Results: The amount of bleeding during operation in single-port group was less than that in three-port group, the hospitalization time was shorter than that in three-port group, and the operation time was longer than that in three-port group (P<0.05). There was no significant difference in the number of lymph node dissection, postoperative drainage time and postoperative drainage volume between the two groups (P>0.05). The levels of cortisol, growth hormone and PGE₂ in the single-port group were lower than those in the three-port group at1d and 7d after operation (P<0.05). The CD3⁺, CD4⁺ and CD4⁺/CD8⁺ in the single-port group were higher than those in the three-port group at 3d after operation (P<0.05). The body pain, social function, emotional function and average score of the single-port group were higher than those of the three-port group at 3 months after operation (P<0.05). There was no significant difference in the total incidence rate of postoperative complications between the two groups (P>0.05). Conclusion: Compared with three-port thoracoscopic radical resection of lung cancer, single-port thoracoscopic radical resection of lung cancer can reduce amount of bleeding, shorten hospitalization time, alleviate body stress response, lessen the damage to immune function, and effectively improve the quality of life of patients.