电视胸腔镜外科手术治疗对纵隔肿瘤患者致痛因子及并发症的影响研究  

Effect of video-assisted thoracic surgery on the treatment of mediastinal tumor patients and its effects on pain factors and complications

作　　者：吕建发[1] 李学刚[1] 陈灯杰[1] 陈智杰 宋艾红 LYU Jianfa;LI Xuegang;CHEN Dengjie;CHEN Zhijie;SONG Aihong(Department of Thoracis Surgery,Hanchuan People＇s Hospital,Hanchuan 431600,Hubei,China)

机构地区：[1]汉川市人民医院胸外科,湖北汉川431600

出　　处：《癌症进展》2018年第13期1608-1611,共4页Oncology Progress

摘　　要：目的研究电视胸腔镜外科手术(VATS)治疗对纵隔肿瘤(MT)患者致痛因子及并发症的影响。方法选取86例MT患者,依据随机数字表法将86例MT患者随机分为VATS组43例和开胸组43例。观察两组患者术前及术后第1天外周血脑内神经肽Y(NPY)、前列腺素E2(PGE2)、缓激肽(BK)、5-羟色胺(5-HT)等致痛因子水平,外周血一氧化氮(NO)、白细胞介素-6(IL-6)、白细胞介素-β(IL-β)水平,术后第1、2天疼痛评分及术后并发症的发生情况。结果术后第1天,VATS组患者的NPY、PGE2、BK、5-HT、NO、IL-6、IL-β均明显低于开胸组,差异均有统计学意义(P<0.01)。术后第1、2天,VATS组患者疼痛评分均明显低于开胸组,差异均有统计学意义(P<0.01)。VATS组患者术后并发症的发生率为4.7%,明显低于开胸组的25.6%,差异有统计学意义(P<0.01)。结论 VATS可以有效地切除MT,降低外周血致痛因子水平,缓解患者疼痛,促进患者康复。Objective To study the effect of video-assisted thoracic surgery （VATS） on the treatment of mediastinal tumor （MT） patients and the pain factors and complications.Method Eightysix patients with MT were enrolled, and they were randomly divided into VATS group （n=43） and thoracotomy group （n=43）. The levels of pain factors, such as neuropeptide Y （NPY） in the brain, prostaglandin E2 （PGE2）, bradykinin （BK） and 5-hydroxytryptamine （5-HT）, in pe- ripheral blood before and 1 day after operation of two groups, the levels of nitric oxide （NO）, interleukin-6 （IL-6） and in- terleukin-13 （IL-13） levels in peripheral blood, postoperative 1 d, 2 d pain score and postoperative complications were ob- served. Result In the first day after operation, the levels of NPY, PGE2, BK, 5-HT, NO, IL-6 and IL-13 in VATS group were significantly lower than those of the thoracotomy group （P〈0.01）. In 1 d and 2 d after operation, the postoperative pain scores VATS group were significantly lower than those in the thoracotomy group （P〈0.01）. The incidence of postop erative complication in VATS group （4.7%） was significantly lower than that of the thoracotomy group （25.6%） （P〈0.01）. Conclusion VATS can effectively remove MT, reduce the level of peripheral blood pain factor, relieve pain and promote patients＇ recovery.

关 键 词：电视胸腔镜外科手术 纵隔肿瘤 致痛因子 

分 类 号：R734.5[医药卫生—肿瘤]