改良经剑突下及肋弓下胸腔镜胸腺切除术对患者术后肺功能及生活质量的影响  

Effects of improved thoracoscopic thymectomy via subxiphoid incision and costal arch incision on pulmonary function and life quality of patients

作　　者：孟庆军[1] 孔繁义[1] 宋翔[1] MENG Qingjun;KONG Fanyi;SONG Xiang(Department of Thoracic Surgery,Central Hospital of Cangzhou City,Hebei,Cangzhou 061000,China)

机构地区：[1]河北省沧州市中心医院胸外科,061000

出　　处：《河北医药》2018年第22期3446-3448,3452,共4页Hebei Medical Journal

基　　金：沧州市科学技术研究与发展指导计划(编号:172302045)

摘　　要：目的研究经剑突下及肋弓下切口胸腔镜治疗胸腺肿瘤对患者肺功能及生活质量的影响。方法选取经剑突下及肋弓下切口胸腔镜60例(剑突下切口组)与传统经胸壁切口60例(胸壁切口组)。分别测定2组患者术前、术后1周、1个月,3个月肺功能[用力肺活量占预计值百分比(FVC%pred)、第1秒用力呼气容积占预计值百分比(FEV1%pred)、1秒率(FEV1/FVC%)、最大分钟通气量占预计值百分比(MVV%pred)、肺弥散功能占预计值百分比(DLCO%pred)]。分别于术前与术后3个月使用调查问卷对患者的生活质量进行评分。结果剑突下切口组术后1周、1个月的肺功能要优于胸壁切口组(P <0. 05)。剑突下切口组术后3个月的肺功能与胸壁切口组比较差异无统计学意义(P> 0. 05)。2组患者术前生活质量评分差异无统计学意义(P> 0. 05),剑突下切口组术后3个月的生活质量各项评分优于胸壁切口组(P <0. 05)。结论经剑突下及肋弓下切口胸腔镜切除胸腺肿瘤作为改良术式,在保护患者肺功能及改善术后生活质量方面具有明显优势。值得临床推广。Objective To observe the effects of improved thoracoscopic thymectomy via incisal opening under xiphoid bone and costal arch on pulmonary function and life quality of patients.Methods A total of 120 patients were divided into subxiphoid incision group(n=60)and chest wall incision group(n=60).The pulmonary function indexes before surgery,at 1week,1m and 3m after surgery were detected and compared between two groups,including FVC%pred,FEV1%pred,FEV1/FVC%,MVV%pred and DLCO%pred.Moreover,the life quality scores of patients were evaluated by questionnaire before surgery and at 3m after surgery.Results The pulmonary function indexes of patients in subxiphoid incision group at 1w and 1m after surgery were superior to those in chest wall incision group(P<0.05).There were no significant differences in pulmonary function indexes between the two groups at 3 m after sutery(P>0.05).Moreover,the life quality scores at 3m after surgery in subxiphoid incision group were superior to those in chest wall incision group(P<0.05).Conclusion The improved thoracoscopic thymectomy via subxiphoid incision and costal arch incision has advantages in improve the pulmonary function and life quality of patients,thus,which is worth using widely in clinical practice.

关 键 词：经剑突下及肋弓下切口 胸腺肿瘤 肺功能 生活质量 

分 类 号：R655.7[医药卫生—外科学]