电视胸腔镜与胸骨劈开行胸腺切除术的研究报告  

作　　者：孙同瑜[1] 黄海涛[1] 马海涛[1] 张光波[1] 

机构地区：[1]苏州大学附属第一医院心胸外科,215000

出　　处：《浙江临床医学》2013年第5期609-611,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨电视胸腔镜技术（VATS）与胸骨正中切开术行胸腺切除术的方法及各自优缺点.方法采用随机对照分析2007年8月至2012年10月47例患者采用VATS经胸径路行胸腺切除术（VATS组）与41例胸骨正中切开行胸腺切除（胸骨切开组）,比较两组在手术时间、术中出血量、术后胸管放置时间、术后并发症、术后镇痛例数及术后住院时间等方面差异.结果两组共88例均顺利完成手术,无术中死亡.手术时间：VATS组（89.3±6.92）min略短于胸骨切开组（110.0±6.43）min;术中出血量：VATS组（55.2±4.07）ml显著少于（112.8±7.96）ml;术后胸管放置时间：VATS组（2.46±1.37）d显著短于胸骨切开组（4.76±1.91）d;术后并发症：两组均无肌无力危象及手术切口感染发生,VATS组术后并发症3例,其中乳糜胸1例,肺部感染2例,无肺漏气、胸内出血、低肺综合征、复张性肺水肿等并发症发生,胸骨切开组术后并发症6例,其中乳糜胸2例,肺部感染4例,无胸骨裂开、胸内出血等并发症发生;术后镇痛例数：VATS组7例显著少于胸骨切开组21例;术后住院时间：VATS组（5.15±2.52）d显著少于胸骨切开组（9.59±2.87）d.结论 VATS下行胸腺切除术安全、可行,与传统的手术方式相比具有创伤小、并发症少、住院时间短、术后恢复快等优势.Objective To discuss the methods and characteristics of video-assisted thoracoscopic surgery and transsternal thymectomy for thymectomy. Method A randomized controlled study,the patients who saw the doctor to our hospital from August 2007 to October 2010 were divided into VATS group（47 cases）and conventional thoracotomy group （41 cases）. The operation time,blood loss,chest drainage time,complications and hospital stay of the two groups were recorded and compared. Result Compared with the conventional group,the patients in the VATS group had shorter operation [（89.3±6.92）min vs（110.0±6.43）min],fewer blood loss[（55.2±4.07）ml vs（112.8±7.96）ml],shorter postoperative drainage time and postoperative hospital stay[（2.46±1.37）d vs（4.76±1.91）d; and（5.15±2.52） d vs（9.59±2.87）d]. There were fewer complications in the VATS group. In the VATS group,1 patient developed chylothorax and 2 had lung infection. In the conventional group,2 patients developed chylothorax and 4 had lung infection. Conclusion Compared with traditional operation method,it has the advantage of smaller trauma,lower rate of complication, shorter hospitalization time,and faster recovery,which all reflect the more and more good clinical application prospect.

关 键 词：电视胸腔镜技术 胸骨切开 胸腺切除术 

分 类 号：R734.2[医药卫生—肿瘤]