目的：探究单孔胸腔镜肺段切除术治疗早期非小细胞肺癌（NSCLC）对患者肺功能、血清创伤反应和远期转移的影响。方法：从我院2020年4月—2021年9月期间收治的200例早期NSCLC患者中,使用计算机随机生成数字,将其分为对照组（100例）和观察组（100例）。对照组接受单孔胸腔镜肺叶切除手术,而观察组接受单孔胸腔镜肺段切除手术。比较两组患者手术情况,手术前后的肺功能指标[肺活量（FVC）、用力呼气一秒量（FEV1）以及FEV1/FVC]、血清指标中[前列腺素（PGE2）、皮质醇（Cor）和C反应蛋白（CRP）]的变化;比较两组患者癌胚抗原（CEA）、细胞角蛋白19片段（CYFRA21-1）和鳞状细胞癌抗原（SCC-Ag）的表达,并通过Kaplan-Meier曲线检验生存及远期转移情况;比较两组并发症发生情况。结果：观察组术中出血量较对照组少,手术持续时间较短而淋巴结清扫数目方面两组之间差异不显著;术后3个月,两组患者的肺功能参数FVC、FEV1和FEV1/FVC水平均较术前明显下降,但观察组的下降幅度相对较小,与对照组相比具有显著性差异;术后1个月,两组患者的血清PGE2、Cor和CRP水平均较术前明显升高,但观察组的升高幅度相对较小,与对照组相比具有显著性差异;两组CEA、CYFRA21-1和SCC-Ag均较术前显著降低,且观察组于对照组更低;术后两年随访显示,两组转移情况均较少,无瘤生存率两组没有显著差异;此外,两组并发症发生情况差异不显著。结论：单孔胸腔镜肺段切除术在治疗NSCLC相较于肺叶切除术能减轻创伤反应,维持肺功能,并降低肿瘤复发和转移风险。

Objective To explore the effect of single-port thoracoscopic segmentectomy on lung function, serum trauma response and long-term metastasis in patients with early non-small cell lung cancer (NSCLC). Methods 200 patients with early NSCLC admitted to our hospital from April 2020 to September 2021 were divided into the control group (100 cases) and observation group (100 cases) by using a computer to randomly generate numbers. The control group received single-port thoracoscopic lobectomy while the observation group patients recceived single-port thoracoscopic segmentectomy. The surgical conditions of the two groups was compared, including lung function [forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and FEV1/FVC ratio], serum trauma response indicators [prostaglandin (PGE2), cortisol (Cor) and C-reactive protein (CRP) ] and tumor cell carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1) and squamous cell carcinoma antigen (SCC-Ag). The survival and long-term metastasis were tested by Kaplan-Meier curve, and the complications were compared. Results Compared with control group, the intraoperative blood loss in observation group was less and the surgical duration was shorter, but the number of lymph nodes dissection was not significantly different between the two groups. At 3 months after surgery, the lung function parameters FVC, FEV1 and FEV1/FVC in both groups were significantly decreased compared with those before surgery, but the decreases were relatively small in observation group, which had significant differences compared to control group. Serum levels of PGE2, Cor and CRP in the two groups at 1 month after surgery were significantly increased compared with those before surgery, but the increases in observation group were relatively small compared with those in control group. The levels of CEA, CYFRA21-1 and SCC-Ag in both groups was significantly reduced compared to before surgery, and the levels in observation group were lower than those in control group. At 2 years after surgery, metastasis was less in the two groups, and there was no significant difference in disease-free survival between the two groups. In addition, the complications revealed no obvious differences between the two groups. Conclusion Compared with lobectomy, single-port thoracoscopic segmentectomy in the treatment of NSCLC can better relieve the trauma response, maintain the lung function, and reduce the risk of tumor recurrence and metastasis.