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与分叶切除相比,分叶切除可以降低术后认知功能障碍的风险
Nailiang Zang1,2, Wei Shen1, Shiyin Li3
1Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, Guangzhou, China.
概括
在早期非小细胞肺癌患者中,分叶切除显著降低了术后认知功能障碍 (POCD) 的风险,而不是分叶切除. 这一发现支持手术后更好的认知结果的亚叶切除.
科学领域:
- 胸部外科手术 胸部外科手术
- 在瘤学瘤学.
- 神经科学是一个神经科学.
背景情况:
- 亚叶切除 (切除,细分切除) 是对早期非小细胞肺癌的叶切除的可行替代方案.
- 手术后认知功能障碍 (POCD) 是主要手术后的一个问题,包括肺癌切除.
研究的目的:
- 在早期非小细胞肺癌患者中,比较分叶下切除和分叶切除之间的POCD发病率.
- 评估外科手术对肺癌手术后短期认知功能的影响.
主要方法:
- 一项前性队列研究,涉及335名接受亚叶切除或叶片切除的患者.
- 使用蒙特利尔认知评估和最低心理状态检查,在手术前和后评估认知功能.
- 倾向性得分匹配 (PSM) 用于平衡群体之间的人口特征.
主要成果:
- 在手术后1天和1个月的POCD发病率较低,在匹配前的亚叶皮组 (5.5%与18.2%,P < 0.001;7.9%与21.8%,P < 0.001).
- 在PSM之后,分叶切除仍然显示1天 (5.3%对17.3%,P=0.005) 和1个月 (8.3%对18.8%,P=0.018) 的POCD发病率显著降低.
- 最小心理状态检查异常也较低在亚叶片组,特别是在手术后1个月 (P = 0.026后PSM).
结论:
- 与分叶切除相比,分叶切除在预防术后认知功能障碍方面具有显著的优势.
- 这些发现为早期非小细胞肺癌的手术决策提供了有价值的证据,优先考虑认知保存.
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