胸腔镜肺叶切除术治疗老年非小细胞肺癌疗效及术后生存率相关影响因素.docVIP

胸腔镜肺叶切除术治疗老年非小细胞肺癌疗效及术后生存率相关影响因素 　　[摘要] 目的 探讨胸腔镜肺叶切除术治疗老年非小细胞肺癌（NSCLC）的临床疗效以及影响患者术后生存率的相关因素。 方法 回顾性分析2007年1月～2011年1月接受肺叶切除术治疗的老年NSCLC患者72例，其中胸腔镜组39例，开胸手术组33例。比较两组患者术中清扫淋巴结数、引流管拔除天数、术后并发症发生率、术后住院天数以及术后3年生存率；Logistic分析影响胸腔镜组患者术后生存率的相关因素。 结果 胸腔镜组患者术后拔除引流管天数、术后住院天数、术后并发症发生率均明显少于开胸组，差异有显著性（P0.05）。Logistic回归分析结果显示，年龄≥65岁、TNM分期为Ⅲ期、淋巴结转移是老年NSCLC患者胸腔镜肺叶切除术术后3年生存率降低的独立风险因素（P0.05）。结论 胸腔镜手术治疗老年NSCLC患者创伤小，术后恢复较快，3年生存期与开胸手术相当。年龄≥65岁、TNM分期为Ⅲ期、淋巴结转移是造成胸腔镜下老年NSCLC根治术患者术后3年生存率降低的独立风险因素，临床需要根据上述情况对患者进行早期干预。 　　[关键词] 胸腔镜；开胸手术；非小细胞肺癌；生存率；相关因素 　　[中图分类号] R734.2 [文献标识码] B [文章编号] 1673-9701（2014）36-0127-03 　　Thoracoscopic lung cancer radical operation in the treatment of elderly patients with non small cell lung cancer （NSCLC） and related factors influencing the efficacy and postoperative survival rate 　　YE Yongqiang WANG Gang YE Huabin 　　Thoracic Surgery， the Cancer Hospital of Ganzhou City in Jiangxi Province， Ganzhou 341000， China 　　[Abstract] Objective To observe the effect of thoracoscopic lung resection in the treatment of elderly non small cell lung cancer （NSCLC） clinical curative effect and the related factors influencing postoperative survival rate. Methods A total of 72 cases of elderly patients with NSCLC in our hospital from Jan 2007 to Jan 2011， according to the different operation scheme were divided into the thoracoscopic group 39 cases， 33 cases of open chest operation group. The two groups were observed and the general operation situation； clinical follow-up of 3 years for patients， patients were compared between the two groups after three years clinical survival rate； Logistic analysis of the related factors affecting the elderly patients with NSCLC postoperative survival rate. Results Postoperative hospitalization days， postoperative hospital stay， postoperative complication rates of thoracoscopic group were less than the open chest operation group， there was significant difference（P0.05）. Logistic regression analysis showed that age more than 65 years old， TNM sta