二氧化碳人工气胸在胸腔镜侧胸壁入路纵隔肿瘤切除术中的应用  

Application of artificial pneumothorax in thoracoscopic via unilateral approach mediastinal tumor resection

作　　者：张洪九 卢恒孝[2] 胡德宏[2] ZHANG Hongjiu;LU Hengxiao;HU Dehong(Department of Surgery,Weifang Medical University,Weifang 261053,China;Department of Thoracic Surgery,Weifang People’s Hospital)

机构地区：[1]潍坊医学院外科学教研室,山东潍坊261053 [2]潍坊市人民医院胸外科一区

出　　处：《潍坊医学院学报》2021年第2期122-125,共4页Acta Academiae Medicinae Weifang

摘　　要：目的探讨侧胸壁入路应用二氧化碳人工气胸的胸腔镜手术治疗前纵隔肿瘤的应用。方法回顾性分析了潍坊市人民医院2017年1月~2020年6月入治的98例经侧胸壁入路手术治疗前纵隔肿瘤患者的临床资料,根据手术方式分为人工气胸组(气胸组)37例、单操作孔胸腔镜组(单操作孔组)31例和单孔胸腔镜组(单孔组)30例,对比3组患者手术时间、术中出血量、术后前2d平均日引流量、术后第1天VAS评分、术后并发症的差异。结果3组患者的术中出血量比较,人工气胸组及单孔组小于单操作孔组,差异均有统计学意义(P<0.05)。手术时间方面人工气胸组及单操作孔组小于单孔组,差异有统计学意义(P<0.05)。3组术后胸腔引流量差异无统计学意义(P>0.05)。人工气胸组患者术后第1天VAS评分明显短于单操作孔组和单孔胸腔镜组,差异有统计学意义(P<0.05)。3组患者术后并发症发生率比较,差异无统计学意义(P>0.05)。结论与单孔及单操作孔胸腔镜纵隔肿瘤切除手术相比较,应用二氧化碳人工气胸经侧胸壁入路胸腔镜手术治疗纵隔肿瘤能减少术中出血量,减轻术后疼痛,缩短手术时间,值得临床推广。Objective To explore the application of artificial pneumothorax in unilateral approach thoracoscopic.Methods Between January 2017 and June 2020,a total of 98 patients with mediastinal tumors who underwent VATS in our hospital were retrospective reviewed.The 37 patients who underwent thoracoscopic via unilateral approach with artificial pneumothorax were divided in to pneumothorax group;the 31 patients who underwent single utility port VATS were divided into single utility port group,and the other 30 patients who under single-port VATS were divided into single port group.The clinical date,postoperative pain and complications of three groups were compared.Results The operation time in the single-port group was longer than the other two groups;The intraoperative blood loss in the single utility port group was more than the other groups,the difference were statistically significant(P<0.05).The VAS score of the pneumothorax group on the first day was lower than the other two groups,the differences were statistically significant(P<0.05).There were no differences in the total incidence rate of postoperative complications and chest tube drainage between the three groups(P>0.05).Conclusion Compared with single utility port VATS and single-port VATS thoracoscopic mediastinal tumor resection,the application of artificial pneumothorax in thoracoscopic via unilateral approach mediastinal tumor resection can reduce intraoperative blood loss,reduce post operative pain and shorten operation time,which is worthy of clinical application.

关 键 词：纵隔肿瘤 电视胸腔镜手术 人工气胸 

分 类 号：R734.5[医药卫生—肿瘤]