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车国卫, 喻鹏铭, 苏建华, 等. 胸腔镜和开放肺叶切除术对肺癌患者心肺运动耐力的影响[J]. koko体育app 学报(医学版), 2013, 44(1): 122-125.
引用本文: 车国卫, 喻鹏铭, 苏建华, 等. 胸腔镜和开花肺叶肿瘤切除术对肝癌爱美者心肺有氧运动耐力的危害[J]. 河北大家学报(医疗版), 2013, 44(1): 122-125.
CHE Guo-wei, YU Peng-ming, SU Jian-hua, et al. Cardio-pulmonary Exercise Capacity in Patients with Lung Cancers: a Comparison Study Between Video-assisted Thoracoscopic Lobectomy and Thoracotomy Lobectomy[J]. Journal of Sichuan University (Medical Sciences), 2013, 44(1): 122-125.
Citation: CHE Guo-wei, YU Peng-ming, SU Jian-hua, et al. Cardio-pulmonary Exercise Capacity in Patients with Lung Cancers: a Comparison Study Between Video-assisted Thoracoscopic Lobectomy and Thoracotomy Lobectomy[J]. Journal of Sichuan University (Medical Sciences), 2013, 44(1): 122-125.

胸腔镜和开放肺叶切除术对肺癌患者心肺运动耐力的影响

Cardio-pulmonary Exercise Capacity in Patients with Lung Cancers: a Comparison Study Between Video-assisted Thoracoscopic Lobectomy and Thoracotomy Lobectomy

  • 摘要: 目的 研究常规开胸和电视胸腔镜肺叶切除术对肺癌患者术后心、肺运动耐力的影响,探讨微创手术在促进肺快速康复和改善患者生活质量中的作用。 方法 从2010年9月至2011年12月连续138例肺癌患者分为开胸组(70例)和电视胸腔镜(VATS)肺叶切除组(68例),两组患者临床特征相似。检测患者术前、术后第7 d和第30 d肺功能及心肺康复运动耐力的相关指标,其中DE Morton指数以圣乔治问卷(术后第7 d和第30 d)进行分析。 结果 ①术后第7 d VATS组第1 s用力呼气容积(FEV1)和峰值呼气流量(PEF)实测值(1.64±0.21) L,(310.58±30.13) L/min高于开胸组(1.34±0.11) L,(270.18±25.67) L/min,P<0.05;②术后第7 d VATS组疲劳指数和呼吸困难指数(0.27±0.08, 0.28±0.17)均低于开胸组(0.44±0.10,0.39±0.09),P<0.05;③术后第7、30 d VATS组6 min步行距离(490.57±118.33) m,(524.32±140.87) m均高于开胸组(395.07±100.19) m,(471.10±118.57) m,P<0.05。④术后第7 d VATS组DE Morton指数(74.58±16.23)高于开胸组(55.87±14.79),P<0.05;⑤术后引流管时间VATS组(25.96±15.42) h短于开胸组(41.84±21.24) h,P<0.05;术后住院时间VATS组(3.14±2.31) d短于开胸组(5.91±4.24) d,P<0.05;平均住院日VATS组(6.54±2.76) d短于开胸组(9.67±4.31) d,P<0.05。 结论 电视胸腔镜肺叶切除提高心肺功能,改善运动耐力而促进快速恢复并提高肺癌患者术后的生活质量。  
    Abstract: Objective To determine the effect of video-assisted thoracoscopic lobectomy on the pulmonary rehabilitation of patients with lung cancers. Methods Between September 2010 and December 2011, 138 patients with lung cancers were treated with lobectomy:68 using video-assisted thoracoscopic surgery (VATS) and 70 using thoracotomy. The preoperative and postoperative (7 d and 30 d) pulmonary functions and Cardio-pulmonary Exercise Capacities as well as postoperative (7 d and 30 d) DE Morton Index of the two groups of patients were assessed. The two groups of patients had similar in clinical characteristics. Results ① Patients in the VATS group had greater FEV1 (1.64 ±0.21) L and PEF(310.58±30.13) L/min on the 7 d after operations than those with thoracotomyFEV1 (1.34±0.11) L and PEF (270.18±25.67) L/min,P<0.05. ② Patients in the VATS group had lower fatigue index (0.27±0.08) and dyspnea index (0.28±0.17) on the 7 d after operations than those with thoracotomy (0.44±0.10 fatigue index and 0.39±0.09 dyspnea index),P<0.05. ③ Patients in the VATS group had longer 6-min walking distance on the 7 d(490.57±118.33) m and 30 d(524.32±140.87) m after operations than those with thoracotomy(395.07±100.19) m at 7 d and (471.10±118.57) m at 30 d,P<0.05. ④ Patients in the VATS group had higher DE Morton index (74.58±16.23) on the 7 d after operations than those with thoracotomy (55.87±14.79),P<0.05. Conclusion VATS lobectomy for curative lung cancer resection appears to provide a superior functional health recovery compared with thoracotomy.  
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