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[单孔与三孔电视辅助胸腔镜肺癌手术的急慢性疼痛比较研究]

[A Comparative Study of Acute and Chronic Pain between Single Port and Triple Port Video-assisted Thoracic Surgery for Lung Cancer].

作者信息

Li Caiwei, Xu Meiqing, Xu Guangwen, Xiong Ran, Wu Hanran, Xie Mingran

机构信息

Department of Thoracic Surgery, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), Hefei 230001, China.

出版信息

Zhongguo Fei Ai Za Zhi. 2018 Apr 20;21(4):279-284. doi: 10.3779/j.issn.1009-3419.2018.04.09.

Abstract

BACKGROUND

Through the comparative analysis of the acute and chronic pain postoperative between the single port and triple port video-assisted thoracic surgery to seek the better method which can reduce the incidence of acute and chronic pain in patients with lung cancer.

METHODS

Data of 232 patients who underwent single port -VATS (n=131) or triple port VATS (n=101) for non-small cell lung cancer (NSCLC) on January 1, 2016 to June 30, 2017 in our hospital were analyzed. The clinical and operative data were assessed, numeric rating scale (NRS) was used to evaluate the mean pain score on the 1th, 2th, 3th, 7th, 14th days, 3th months and 6th months postoperative.

RESULTS

Both groups were similar in clinical characteristics, there were no perioperative death in two groups. In the 1th, 2th, 7th, 14th days and 3th, 6th months postoperative, the NRS score of the single port group was superior, and the difference was significant compared with the triple port (P<0.05). There was no statistically significant difference between the two groups in operative time, blood loss, postoperative hospitalization time, duration of chest tube, the NRS scores in the 3 d (P>0.05). Univariate and multivariate analysis of the occurrence on the chronic pain showed that the operation time, surgical procedure and the 14th NRS score were risk factors for chronic pain (P<0.05).

CONCLUSIONS

The single port thoracoscopic surgery has an advantage in the incidence of acute and chronic pain in patients with non-small cell lung cancer. Shorter operative time can reduce the occurrence of chronic pain. The 14th day NRS score is a risk factor for chronic pain postoperative.

摘要

背景

通过单孔与三孔电视辅助胸腔镜手术术后急性和慢性疼痛的对比分析,探寻降低肺癌患者急慢性疼痛发生率的更佳方法。

方法

分析2016年1月1日至2017年6月30日在我院因非小细胞肺癌(NSCLC)接受单孔-VATS(n = 131)或三孔VATS(n = 101)手术的232例患者的数据。评估临床和手术数据,采用数字评分量表(NRS)评估术后第1、2、3、7、14天、3个月和6个月的平均疼痛评分。

结果

两组临床特征相似,两组均无围手术期死亡。术后第1、2、7、14天及3、6个月,单孔组NRS评分更优,与三孔组相比差异有统计学意义(P < 0.05)。两组手术时间、失血量、术后住院时间、胸管留置时间、术后3天NRS评分差异无统计学意义(P > 0.05)。慢性疼痛发生情况的单因素和多因素分析显示,手术时间、手术方式及术后第14天NRS评分是慢性疼痛的危险因素(P < 0.05)。

结论

单孔胸腔镜手术在非小细胞肺癌患者急慢性疼痛发生率方面具有优势。较短的手术时间可降低慢性疼痛的发生。术后第14天NRS评分是慢性疼痛的危险因素。

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[Evolution and Development Trend of Lung Cancer Surgical Incision].[肺癌手术切口的演变与发展趋势]
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