杨锦雷, 余兵, 窦光华, 吴伟, 王可兵. CT引导下Hook-wire定位辅助胸腔镜手术治疗早期NSCLC效果及其对血清肿瘤标志物和术后复发影响[J]. 蚌埠医学院学报, 2021, 46(9): 1183-1186, 1191. DOI: 10.13898/j.cnki.issn.1000-2200.2021.09.008
    引用本文: 杨锦雷, 余兵, 窦光华, 吴伟, 王可兵. CT引导下Hook-wire定位辅助胸腔镜手术治疗早期NSCLC效果及其对血清肿瘤标志物和术后复发影响[J]. 蚌埠医学院学报, 2021, 46(9): 1183-1186, 1191. DOI: 10.13898/j.cnki.issn.1000-2200.2021.09.008
    YANG Jin-lei, YU Bing, DOU Guang-hua, WU Wei, WANG Ke-bing. Effect of CT-guided Hook-wire positioning assisted thoracoscopic surgery in the treatment of early NSCLC, and its influence on serum tumor markers and postoperative recurrence[J]. Journal of Bengbu Medical College, 2021, 46(9): 1183-1186, 1191. DOI: 10.13898/j.cnki.issn.1000-2200.2021.09.008
    Citation: YANG Jin-lei, YU Bing, DOU Guang-hua, WU Wei, WANG Ke-bing. Effect of CT-guided Hook-wire positioning assisted thoracoscopic surgery in the treatment of early NSCLC, and its influence on serum tumor markers and postoperative recurrence[J]. Journal of Bengbu Medical College, 2021, 46(9): 1183-1186, 1191. DOI: 10.13898/j.cnki.issn.1000-2200.2021.09.008

    CT引导下Hook-wire定位辅助胸腔镜手术治疗早期NSCLC效果及其对血清肿瘤标志物和术后复发影响

    Effect of CT-guided Hook-wire positioning assisted thoracoscopic surgery in the treatment of early NSCLC, and its influence on serum tumor markers and postoperative recurrence

    • 摘要:
      目的探讨CT引导下Hook-wire定位辅助胸腔镜手术治疗早期非小细胞肺癌(NSCLC)的效果及其对血清肿瘤标志物和术后复发的影响。
      方法选取早期NSCLC病人98例,按照随机数字表法分为观察组和对照组,各49例。观察组采用CT引导下Hook-wire定位辅助胸腔镜手术,对照组仅采用胸腔镜手术。比较2组手术情况、手术前后血清肿瘤标志物指标、肺功能指标和并发症发生情况,并随访12个月,统计2组疾病复发率。
      结果观察组术中失血量、术后引流量和胸腔置管引流时间、住院时间均明显少于对照组(P < 0.01)。术后1 d,2组血清癌胚抗原、细胞角质蛋白19片段抗原21-1、糖类抗原50水平均较术前降低(P < 0.05),但组间比较差异均无统计学意义(P>0.05)。术后2周、1个月,2组最大通气量、第1 s用力呼气量、用力肺活量均较术前降低(P < 0.05),但观察组均明显高于对照组(P < 0.01)。观察组并发症发生率为6.12%(3/49),与对照组的10.20%(5/49)比较差异无统计学意义(P>0.05)。术后12个月,观察组疾病复发率为2.04%(1/49),低于对照组的14.29%(7/49)(P < 0.05)。
      结论CT引导下Hook-wire定位辅助胸腔镜手术治疗早期NSCLC定位精准,对肺功能损伤小、恢复快,且能降低疾病复发风险。

       

      Abstract:
      ObjectiveTo investigate the effects of CT-guided Hook-wire positioning assisted thoracoscopic surgery in the treatment of early non-small cell lung cancer(NSCLC), and its influence on the serum tumor markers and postoperative recurrence.
      MethodsNinety-eight patients with early NSCLC were selected, and divided into the observation group and control group according to the random number table method(49 cases each group).The observation group were treated with CT-guided Hook-wire positioning assisted thoracoscopic surgery, and the control group were treated with thoracoscopic surgery.The operation status, serum tumor marker indicatorscytokeratin 19, fragment antigen 21-1(CYFRA21-1), carcinoembryonic antigen(CEA) and carbohydrate antigen 50(CA50) and lung function indexesforced vital capacity(FVC), maximum ventilation(MVV), forced expiratory volume in the first second(FEV1) before and afteroperation, and complications were compared between two groups.All patients were followed up for 12 months, and the recurrence rates in two groups were counted.
      ResultsThe intraoperative blood loss, postoperative drainage, thoracic catheter drainage time and hospitalization time in observation group were significantly less than those in control group(P < 0.01).After 1 d of operation, the serum levels of CEA, CYFRA21-1 and CA50 in two groups decreased compared with those before surgery(P < 0.05), but there was no statistical significance between two groups(P>0.05).After 2 weeks and 1 month of operation, the MVV, FVC and FEV1 in two groups decreased compared with those before operation(P < 0.05), but which in observation group was significantly higher than that in control group(P < 0.01).The incidence rates of complications in the observation group and control group were 6.12%(3/49) and 10.20%(5/49), respectively, and the difference of which was not statistically significant(P>0.05).After 12 months of surgery, the recurrence rate of disease in observation group2.04%(1/49) was lower than that in control group14.29% (7/49) (P < 0.05).
      ConclusionsThe use of CT-guided Hook-wire positioning assisted thoracoscopic surgery in the treatment of early NSCLC is accurate, little damage to lung function, quick recovery, and can reduce the risk of disease recurrence.

       

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