Ⅰ型下行性坏死性纵隔炎的两种手术方式疗效分析  

Analysis on curative effects of two surgical methods for typeⅠdescending necrotizing mediastinitis

作　　者：周振强 辛五群 赵璞 刘青锋[1,2] 董冠中 汤金星[1,2] 何苡 ZHOU Zhenqiang;XIN Wuqun;ZHAO Pu;LIU Qingfeng;DONG Guanzhong;TANG Jinxing;HE Yi(Henan University People′s Hospital,Zhenzhou,Henan 450003,China;Henan Provincial People′s Hospital,Zhengzhou,Henan 450003,China)

机构地区：[1]河南大学人民医院,郑州450003 [2]河南省人民医院,郑州450003

出　　处：《重庆医学》2020年第6期942-945,共4页Chongqing medicine

摘　　要：目的对比分析治疗Ⅰ型下行性坏死性纵隔炎的最佳手术方式。方法随机抽取2013年3月至2018年3月于河南大学人民医院采取颈纵隔脓肿切开引流术(A组)及颈部联合胸腔镜下纵隔脓肿切开引流术(B组)两种手术方式治疗的Ⅰ型下行性纵隔炎患者各30例,研究手术预后。结果A组死亡2例、再次手术者9例,B组死亡1例,再次手术者2例,B组再次手术率低于A组、平均住院时间明显短于A组,差异有统计学意义(P<0.05),但年龄、病死率、手术切口缝合时间、体质量指数(BMI)两组间差异无统计学意义(P>0.05)。结论颈部联合胸腔镜下纵隔脓肿切开引流术治疗Ⅰ型下行性坏死性纵隔炎再次手术率低、住院时间短、预后较好。Objective To study and analyze the best operation method for treating type I descending necrotizing mediastinitis.Methods Each 30 cases of type I descending mediastinitis respectively treated by cervical mediastinal abscess incision drainage and neck combined with thoracoscopic mediastinal abscess incision drainage in the Henan University People′s Hospital from March 2013 to March 2018 were randomly selected and divided into the group A and B.Then the postoperative prognostic effects were studied.Results In group A,there were 2 cases of death and 9 cases of reoperation;in the group B,there was 1 case of death and 2 cases of reoperation;the reoperation rate and average hospitalization time in the group B were significantly lower than those in the group A with statistically significant differences(P<0.05).However the age,mortality,surgical incision suture time and BMI had no statistically significant difference between the two groups(P>0.05).Conclusion For the type I descending necrotizing mediastinitis,neck combined with thoracoscopic mediastinal abscess incision drainage is a better operation method with low reoperation rate,short hospital stay and good prognosis.

关 键 词：下行性坏死性纵隔炎 颈部切开纵隔引流 电视胸腔镜手术 

分 类 号：R655.5[医药卫生—外科学]