无肌肉损伤小切口在肺癌患者肺切除术中的价值  

Clinical Research of Muscle-Sparing Modified Small Incision Thoracotomy in Treatment of Patients with Lung Cancer by Pneumonectomy

作　　者：夏平[1,2] 黄文婷[2] 蒋彬[2] 钱凯[2] 韩睿[2] 何勇[3] 

机构地区：[1]安康市中医院胸心外科,陕西安康25000 [2]第三军医大学大坪医院野战外科研究所全军胸外科中心,重庆400042 [3]野战外科研究所呼吸科

出　　处：《解放军医药杂志》2013年第1期33-35,38,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：第三军医大学大坪医院野战外科研究所临床新技术项目资助课题(2011015)

摘　　要：目的探讨应用无肌肉损伤小切口肺切除术治疗肺癌的临床价值。方法将92例行肺切除术的肺癌患者,根据剖胸切口的不同分为无肌肉损伤小切口组(n=42)及传统后外侧切口组(n=50),比较两种手术方式术中及术后相关指标。结果全组无手术死亡和严重并发症病例。无肌肉损伤小切口组切口长度、开胸失血量、关胸时间、手术后疼痛程度、肩关节活动能力指标均优于传统后外侧切口组(P<0.05);两组清扫淋巴结数目差异无统计学意义(P>0.05)。结论采用无肌肉损伤小切口肺切除术治疗肺癌,开关胸时间短,手术并发症发生率低,淋巴结清扫彻底,对上肢功能影响小,患者术后恢复快,值得临床推广。Objective To explore the clinical value of muscle-sparing modified small incision surgery in treat- ment of lung cancer by pneumonectomy. Methods A total of 92 patients with lung cancer treated by pulmonary resection in our hospital randomly divided into muscle sparing modified small incision group （group A, n = 42） and posterolateral incision group （group B, n = 50） , and the correlative indexes intraoperative and postoperative of the two groups were compared. Results There was not complication and death in the two groups. The average length of skin incision, blood loss in thoracotomy, closed chest time, postoperative pain degree and postoperative shoulder joint locomotor activity index in group A were significant better than those of in group B （P 〈 0.05） ; and the difference in number of cleared lymph nodes of the two groups was no statistically significant （P 〉 0.05）. Conclusion The method of muscle sparing modified small incision pneumonectomy in treatment of lung cancer has shorter on-off chest time, less postoperative complications, cleared lymph nodes thoroughly, little influence on upper limb function and quickly postoperative recovery.

关 键 词：肺肿瘤 肺切除术 外科手术 微创性 对比研究 

分 类 号：R734.2[医药卫生—肿瘤]