微创与传统手术治疗胸腺瘤疗效比较  

Effect Comparison between Minimally Invasive Video-assisted and Traditional Thoracic Surgery for Thymoma

作　　者：谭棠基[1] 何发[1] 赵意[1] 

机构地区：[1]广东医学院附属三水医院心胸外科,广东佛山528100

出　　处：《中国现代手术学杂志》2014年第3期182-185,共4页Chinese Journal of Modern Operative Surgery

摘　　要：目的通过比较胸腔镜微创手术与传统手术治疗胸腺瘤的临床疗效及预后，探讨其在胸腺瘤治疗中的临床应用价值。方法回顾性分析2003年6月-2013年6月我院收治的90例胸腺瘤患者的临床资料，按照手术方式分为两组：观察组30例，行全胸腔镜手术或胸腔镜辅助小切口微创手术；对照组60例，行传统开胸手术。观察组合并重症肌无力8例，对照组合并重症肌无力16例。比较两组患者临床疗效。结果观察组手术切口长度、术中出血量和手术时间分别为（6．28±1．37）em，（361．8±176．9）rnl和（158．67±27．81）min，均显著小于对照组的（16．84±5．16）cm，（800．69±235．43）ml和（225．48±37．25）min（P〈0．01）。观察组术后切口疼痛VAS评分、术后引流液量及术后住院时间分别为（3．85±1．24）分，（175．34±71．25）ml和（6．38±3．61）d，均显著少于对照组的（7．36±2．59）分，（341．56±113．74）ml和（9．27±3．48）d（P〈0．01）。两组患者术后并发症发生率比较，观察组明显低于对照组（6．67％VS15．0％），差异有统计学意义（P〈0．05）；两组合并MG患者术后疗效比较无统计学差异（P〉0．05）。结论胸腔镜微创手术治疗胸腺瘤安全有效，具有切口小、术中出血少、术后恢复快、并发症少等优点，值得临床推广应用。Objective To compare the clinical effect of minimally invasive video-assisted thoracic sur- gery and conventional surgery for thymoma, and so as to explore the clinical value of minimally invasive surgery in the treatment of thymoma. Methods A total of 90 cases suffered thymoma admitted from June 2003 to June 2013 were analyzed retrospectively. According to surgical methods, they were divided into two groups： 30 cases received complete video-assisted thoracic surgery or thoracoscopic assisted mini-incision thoracotomy were regarded as the observation group, and 60 cases carried out traditional thoractomy were regarded as the control group. 8 cases were combined myasthenia gravis in the observation group and 16 in the control group. The clinical outcomes were compared between two groups. Results The incision length, intra-operative blood loss and operative time of the observation group was 6.28 -± 1.37 cm, 361.8 -± 176.9 ml and 158.67 ~ 27.81 rain respectively, and all were obviously lower than 16.84 ± 5.16 cm, 800.69 ± 235.43 ml and 225.48 ±37.25 min of the control group（P 〈0.01 ）. The post-operative VAS score of wound pain, post-operative drainage volume and post-operative hospital stay was 3.85 ± 1.24, 175.34 ± 71.25 ml and 6.38 ± 3.61 days in the observation group, and all were remarkable less than 7.36 ± 2.59,341.56 ± 113.74 ml and 9.27 ± 3.48 days in the control group（P 〈0.01 ）. The post-operative complication rate was lower in the observation group than that in the control group（6.67% VS 15.0% ）, and there was statistic difference between two groups（P 〈0. 05）. But no statistic difference in therapeutic prognosis between two groups combined with MG （P 〉 0.05）. Conclusion Minimally invasive video-assisted thoracic surgery is a safe and effective procedure with advantages as small in- cision, less blood loss, faster recovery and fewer complications in the treatment of thymoma, and it is worth fur- ther popularizing.

关 键 词：胸腺瘤 胸腔镜检查 外科手术 微创性 开胸手术 

分 类 号：R736.3[医药卫生—肿瘤]