经剑突下单孔胸腔镜胸腺切除术临床应用的倾向性评分匹配研究  

Clinical application of subxiphoid uni-portal thoracoscopic thymectomy:A propensity score matching study

作　　者：刘政呈[1] 杨如松[1] LIU Zhengcheng;YANG Rusong(Department of Thoracic Surgery,Nanjing Chest Hospital,Nanjing,210029,P.R.China)

机构地区：[1]南京市胸科医院胸外科

出　　处：《中国胸心血管外科临床杂志》2020年第3期318-322,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：南京市医学科技计划重点项目(ZKX17045);江苏省青年医学人才项目(QNRC2016124)

摘　　要：目的分析经剑突下单孔胸腔镜胸腺切除术的安全性、可行性及优势。方法回顾性分析2018年9月至2019年3月我院完成的65例经剑突下单孔胸腔镜胸腺切除术患者的临床资料,并将其作为经剑突下手术组,其中男36例、女29例,年龄49.5(29~71)岁。切口位于剑突下约1 cm处,长约3 cm。另选择2016年1月至2017年12月65例接受经肋间单孔胸腔镜胸腺切除术的患者作为对照组,其中男38例、女27例,年龄48.9(33~67)岁。术前临床诊断为胸腺肿瘤的患者均行全胸腺切除术,术后予祛痰、镇痛等治疗。结果两组患者的一般资料、病灶大小、术中出血量、术后置管时间、术后住院时间、术后病理等差异无统计学意义(P>0.05)。两组患者手术均顺利完成,术后康复顺利。经剑突下手术组术后第1 d、3 d、7 d、30 d的视觉模拟评分低于对照组。结论经剑突下单孔入路可以实现全胸腺切除,且创伤更小、患者术后康复更快。Objective To investigate the safety,feasibility and advantages of subxiphoid uni-portal thoracoscopic thymectomy.Methods Clinical data of 65 patients undergoing subxiphoid uni-portal thoracoscopic thymectomy in our hospital from September 2018 to March 2019 were retrospectively analyzed.They were treated as a subxiphoid surgery group,including 36 males and 29 females,aged 49.5(29-71)years.The incision with the length of about 3 cm was located approximately 1 cm under the xiphoid process.From January 2016 to December 2017,65 patients received intercostal uniportal thoracoscopic thymectomy,who were treated as a control group,including 38 males and 27 females,aged 48.9(33-67)years.All patients who were clinically diagnosed with thymic tumor before surgery were treated with total thymectomy.After surgery,expectoration and analgesia were used.Results There was no statistically significant difference in general clinical data,lesion size,intraoperative blood loss,postoperative catheterization time,postoperative hospital stay and postoperative pathology between the two groups.All operations were successfully completed,and the patients in both groups recovered uneventfully after surgery.Visual analogue scale scores on the 1st,3rd,7th and 30th day after surgery in the subxiphoid surgery group were lower than those in the control group.Conclusion The subxiphoid uni-portal thoracoscopic approach can achieve total thymectomy with less trauma and faster postoperative recovery.

关 键 词：经剑突下 单孔胸腔镜 胸腺切除术 倾向性匹配 

分 类 号：R736.3[医药卫生—肿瘤]