电视胸腔镜治疗纵隔肿瘤94例临床体会  

Video-assisted thoracoscopic surgery for the mediastinal tumor: A report of 94 cases

作　　者：程宏忠[1] 王平[1] 彭浩[1] 吴建强[1] 汪国平[1] 

机构地区：[1]云南省第一人民医院胸外科,云南昆明650032

出　　处：《云南医药》2014年第1期17-20,共4页Medicine and Pharmacy of Yunnan

摘　　要：目的通过使用电视胸腔镜对94例纵隔肿瘤病人的诊治总结得出应用胸腔镜诊治纵隔肿瘤的体会。方法 94例纵隔肿瘤进行胸腔镜下切除。其中男性60例,女性34例。年龄21～75岁平均46.8岁。胸腔镜置于腋中线的第6～7肋间,探查肿瘤生长情况及毗邻后决定另外两个操作孔位置。根据术中探查情况决定手术方式。记录手术时间,出血量,术后胸腔闭式引流时间,胸引量,术后并发症情况等。术后行2月～24月随访,分析临床特点和疗效。结果 67例完全在胸腔镜下完成瘤体切除,其中4例仅行肿瘤活检,17例小切口辅助完成手术,中转开胸6例。术中出血10～600ml,平均106ml。无术中术后输血病例,无二次手术止血病例,术后胸液引流90～893ml,平均250ml。术后在2～6d拔出闭式引流管,平均3.8d。2例术后液气胸调整引流管位置加强引流后痊愈,术后平均住院7.8d,围手术期死亡0例,术后随访死亡2例。结论电视胸腔镜手术适合于大部分纵隔肿瘤的治疗,安全有效,对大多数纵隔肿瘤为一安全有效的方式,值得在大多数有条件的医院推广。Objective To conclude the experience that use the video-assisted thoracoscope for 94 patients with mediastinal tumor. Methods 94 patients with the mediastinal tumor underwent video-assisted thoracoscopic surgery.The study included 60 men and 34 women with the mean age of 46.8 years old. The thoracoscope was placed at axillary line 6 to 7 intercostal. Results 67 cases completely received thoracoscope surgery, 4 case only received tumor biopsies, 17 cases assisted with minithoractorny, and 6 cases were transitted to thoracotomy. Intraoperative bleeding were of 10-800ml（106ml on average）. Postoperative drainage were of 90-893ml（average 250ml）. Removed the drainage tube after 2-6days（average 3.8 days）. 2 cases with pneumothorax was cured by thoracentesis. Average hospital stay of 7.8 days after operation. No case of perioperative death.2 cases died during the follow-up period. Conclusion Video-assisted thoracoscope surgery is suitable for most of the mediastinal tumor＇s treatment, and is safe and effective.For most mediasttoinal tumors,it is a effective methods and to be promoted in most hospitals.

关 键 词：胸腔镜 纵隔肿瘤 治疗 

分 类 号：R616.2[医药卫生—外科学]