单孔电视胸腔镜肺叶切除术治疗早期肺癌的效果及对血清EGFR、VEGF水平及免疫功能的影响

目的:探讨单操作孔电视胸腔镜肺叶切除术治疗早期肺癌的临床效果及对血清表皮生长因子受体(EGFR)、血管内皮生长因子(VEGF)水平和免疫功能的影响。方法:选择2014年2月至2017年2月我院接诊的60例早期肺癌患者,采取随机数表法分作观察组(n=30)与对照组(n=30)。观察组采用单操作孔电视胸腔镜肺叶切除术,对照组采用传统胸腔镜三孔法。比较两组手术用时、切口长度、术中出血量、术后下床活动时间、术后住院时间、拔出引流管时间、术后总引流量,治疗前后血清EGFR、VEGF水平、CD4~+、CD8~+T细胞比例、CD4~+/CD8~+比值、NK比例的变化及不良反应的发生情况。结果:治疗后,观察组的手术用时、术后住院时间、术后下床活动时间及拔出引流管时间均显著短于对照组(P0.05);术中出血量、切口长度及术后总引流量均显著低于对照组(P0.05)。观察组治疗后血清EGFR、VEGF表达均明显低于对照组(P0.05),CD4~+T、CD8~+T、CD4~+T/CD8~+T、NK水平均显著高于对照组(P0.05),不良反应总发生率显著低于对照组(P0.05)。结论:单操作孔电视胸腔镜肺叶切除术用于治疗早期肺癌的创伤小,患者恢复快,可有效降低血清中EGFR、VEGF的表达,改善其免疫功能,减少不良反应的发生。

Curative Efficacy of Single Utility Port Complete Video-assisted Thoracic Surgery Lobectomy in the Treatment of Patients with Early Lung Cancer and Its Effects on the Serum EGFR,VEGF levels and Immune Function

ABSTRACT Objective: To investigate the clinical effect of single-operation fluoroscopic thoracoscopic lobectomy in the treatment of early lung cancer and serum epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF) levels as well as the immune function. Methods: 60 patients of early lung cancer who were treated from February 2014 to February 2017 in our hospital were selected as the research objects. According to the random number table method, those patients were divided into the observation group ( n = 30) and the control group ( n = 30). The observation group was treated with single utility port complete video-assisted thoracic surgery lolobectomy, while the control group was treated with traditional thoracoscopic three - hole method. Then the surgical use, cut length, intraoperative blood loss, postoperative time to get out of bed, postoperative hospital stay, pull out the drainage tube time, postoperative total drainage, serum EGFR, VEGF, CD4 ⁺ and CD8 ⁺ T cells , CD4 ⁺ / CD8⁺ ratio , NK ratio changes and the incidence of adverse reactions were compared between two groups. Results: After treatment, the hospitalization time, time of bed removal and time of drainage were significantly shorter than those of the control group (P<0.05). The intraoperative blood loss, incision length and total postoperative drainage were significantly lower than those of the control group (P <0.05). The serum EGFR and VEGF levels of observation group were significantly lower than those of the control group (P <0.05). The CD4 ⁺ T, CD8 ⁺ T, CD4 ⁺ T / CD8 ⁺ T and NK of observation group were significantly higher than those of the control group (P <0.05). The incidence of adverse reactions in the observation group was significantly lower than that of the control group (P <0.05) Conclusion: Single-operation video-assisted thoracoscopic lobectomy could effectively reduce the serum EGFR, VEGF levels, improve the immune function and reduce in the treatment of patients with early lung cancer with small trauma.