摘要
目的 比较不同入路胸腔镜下前纵隔肿瘤切除术的应用效果。方法 选取2020年1月至2021年6月信阳市中心医院收治的行前纵隔肿瘤切除手术患者68例,按手术入路不同,将经剑突下入路的34例作为观察组,将经侧胸入路的34例作为对照组,对比两组患者手术指标、术后疼痛程度、手术前后血清疼痛介质水平、术后并发症发生率、生活质量改善情况。结果 观察组手术时间长于对照组,术后引流量少于对照组,住院费用低于对照组,住院时间、术后胸腔引流时间均短于对照组,术后2 d、3 d疼痛视觉模拟评分(VAS)低于对照组,术后7 d 5-HT(5-羟色胺)、NPY(神经肽Y)、PGE2(前列腺素E2)、ATCH(促肾上腺皮质激素)水平低于对照组,术后并发症发生率(8.82%)低于对照组(32.35%),术后3个月各项生活质量评分高于对照组,两组对比差异有统计学意义(P<0.05)。结论 在胸腔镜下前纵隔肿瘤切除手术中应用剑突下入路可取得很好的效果,还有助于减轻患者术后疼痛,预防各类并发症的发生。
Objective To compare the effects of thoracoscopic resection of anterior mediastinal tumor.Methods A total of 68 patients who underwent anterior mediastinal tumor resection in our hospital from January 2020 to June 2021 were selected as the research subjects.They were divided into observation group(34 cases) and control group(34 cases) by random number table method.The approaches were subxiphoid approach and lateral thoracic approach,respectively.Surgical indicators,postoperative pain,serum pain mediators before and after surgery,incidence of postoperative complications and improvement of quality of life were compared between the two groups.Results Observation group was shorter than control group in operation time,postoperative chest drainage time,hospitalization time,postoperative drainage volume,hospitalization cost,2 D and 3 D postoperative VAS score,and 7 d postoperative 5-HT,NPY,PGE2,ATCH levels.The incidence of postoperative complications(8.82%) was lower than that of the control group(32.35%),and the scores of quality of life 3 months after surgery were higher than that of the control group(P<0.05).Conclusion The application of the subxiphoid approach in thoracoscopic anterior mediastinal tumor resection can achieve good results,and is helpful to relieve postoperative pain and prevent various complications.
作者
陈达博
程再轩
王瑞
CHEN Da-bo;CHENG Zai-xuan;WANG Rui(Department of Cardiothoracic Surgery,Xinyang Central Hospital,Xinyang,Henan 464000,China)
出处
《医药论坛杂志》
2022年第17期39-42,共4页
Journal of Medical Forum
关键词
胸腔镜
前纵隔肿瘤切除术
经侧胸入路
经剑突下入路
术后并发症发生率
Thoracoscopy
Resection of anterior mediastinal tumor
Lateral thoracic approach
Approach via xiphoid process
Incidence of postoperative complications
