三种手术方式治疗前纵隔肿瘤的疗效对比研究  

Comparative analysis of the curative effect of three surgical methods on anterior mediastinal tumors

作　　者：李雄 刘霞[2] 马生茂[1] 李有金[1] 陈永祥[1] 牛涛[1] LI Xiong;LIU Xia;MA Shengmao;LI Youjin;CHEN Yongxiang;NIU Tao(Department of Thoracic Surgery,People’s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China)

机构地区：[1]宁夏回族自治区人民医院胸外科,宁夏银川750002 [2]宁夏回族自治区人民医院皮肤科,宁夏银川750002

出　　处：《陕西医学杂志》2021年第1期48-50,54,共4页Shaanxi Medical Journal

摘　　要：目的:分析经剑突肋缘下入路、胸腔镜侧胸入路及纵劈胸骨前纵隔肿瘤切除患者的临床资料,比较三种手术方式的疗效。方法:收集三种手术方式的前纵隔肿瘤患者共48例,并分为三组,其中剑突肋缘下15例;胸腔镜侧胸入路18例;纵劈胸骨15例。比较分析三组的手术时间,术中出血量,术后总的引流量,术后留置引流管时间,术后1 d疼痛评分,术后住院时间等情况。结果:手术均顺利完成。经剑突肋缘下组手术时间及术后1 d疼痛评分比其他两组显著缩短(P<0.05);胸腔镜侧胸入路组与纵劈胸骨组手术时间差异无统计学意义;经剑突肋缘下入路与胸腔镜侧胸入路相比,术中出血量及术后住院时间差异无统计学意义,但两组均少于纵劈胸骨组(P<0.05);胸腔镜侧胸入路组术后1 d疼痛评分、术后总的胸引流量及胸引管留置时间低于纵劈胸骨组(P<0.05)。结论:胸腔镜侧胸入路具有创伤小、出血少、疼痛轻、住院时间短等特点.而经剑突肋缘下入路,除以上特点外,术后无需放置引流管,且在缩短手术时间、减轻术后疼痛方面更具有优势。Objective:To analyze the clinical data of patients undergoing anterior mediastinal tumor resection with three surgical methods(subcostal approach through the xiphoid process,thoracoscopic lateral thoracic approach,and sternotomy)and compare the efficacy of the three surgical methods.Methods:A total of 48 patients with anterior mediastinal tumors under three surgical methods were collected,including 15 cases treated with subcostal approach through the xiphoid process,18 cases treated with thoracoscopic lateral thoracic approach,and 15 cases treated with sternotomy.The operation time,intraoperative blood loss,total postoperative drainage volume,postoperative indwelling drainage tube time,postoperative pain score on the first day,postoperative hospital stay were compared and analyzed in the three groups.Results:The operations were successfully completed.The operation time and pain score of patients with subcostal approach through the xiphoid process were significantly shorter than those of the other two groups(P<0.05).There was no significant difference in the operation time between the patients with thoracoscopic lateral thoracic approach and the patients with sternotomy.Compared with the patients with thoracoscopic lateral thoracic approach,the patients with subcostal approach through the xiphoid process had no significant difference in intraoperative blood loss and postoperative hospital stay,but the two groups were less than the patients with sternotomy(P<0.05).The pain score,the total amount of chest guidance and the indwelling time of the chest guidance tube on the first day after surgery in the patients with thoracoscopic lateral thoracic approach were lower than those in the patients with sternotomy(P<0.05).Conclusion:The thoracoscopic lateral thoracic approach has the characteristics of less trauma,less bleeding,light pain,and short hospital stay.In addition to the above features,the subcostal approach through the xiphoid process does not require a drainage tube after surgery,and has advantages in shortenin

关 键 词：胸腔镜 前纵隔肿瘤 剑突肋缘下 胸腔镜侧胸入路 劈开胸骨术 

分 类 号：R734.5[医药卫生—肿瘤]