胸腔镜剑突下切口与肋间切口治疗前纵隔肿瘤的对照研究  

A comparative study of thoracoscopic subxiphoid incision and intercostal incisionin the treatment of anterior mediastinal tumors

作　　者：吕治平 刘阳[1] 张升[1] 何伟[1] 何进喜[1] 仇睿[1] 韩育宁[1] LV Zhiping;LIU Yang;ZHANG Sheng;HE Wei;HE Jinxi;QIU Rui;HAN Yuning(Department of Thoracic Surgery,The General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院普胸外科,宁夏银川750004

出　　处：《宁夏医学杂志》2021年第8期710-713,共4页Ningxia Medical Journal

基　　金：宁夏重点研发计划项目(2018BEG03024)。

摘　　要：目的比较胸腔镜经剑突下切口与胸腔镜经肋间切口手术治疗前纵隔肿瘤的临床疗效差异。方法回顾性分析接受胸腔镜前纵隔肿瘤切除术175例患者的临床资料,根据不同手术方式,分为经剑突下切口组(A组,n=110)与经肋间切口组(B组,n=65)。收集2组患者性别、年龄、美国麻醉医师协会分级(ASA分级)、肿瘤大小、术后病理类型、手术时间、术中出血量、术后带管时间、总引流量、视觉模拟疼痛评分(VAS评分)、术后住院时间、术后并发症的发生率,比较2组患者以上指标的统计学差异。结果2组患者手术均获得成功,与B组相比,A组患者在手术时间、术后带管时间、术后总引流量、术后24 hVAS评分及肺部感染发生率方面均优于B组(P<0.05)。结论胸腔镜经剑突下切口前纵隔肿瘤切除术可显著缩短手术时间及术后带管时间短,减轻手术疼痛,减少术后引流量及术后肺部感染并发症,促进患者的术后恢复。Objective To compare the clinical efficacy of thoracoscopic subxiphoid incision and thoracoscopic intercostal incision in the treatment of anterior mediastinal tumors.Methods The clinical data of 175 patients who underwent thoracoscopic anterior mediastinal tumor resection were analyzed retrospectively.According to different surgical methods,the cases were divided into subxiphoid incision group(group A,n=110 cases)and intercostal incision group(group B,n=65 cases).The clinical data of sex,age,ASA grade,tumor size,postoperative pathological type,operation time,intraoperative bleeding,postoperative tube time,total drainage,VAS,postoperative hospital stay and the incidence of postoperative complications were collected.The perioperative data of the two groups were compared.Results All operations in both groups were successful.Compared with group B,patients in group A were better in terms of operation time,postoperative tube time,postoperative total drainage volume,24-hour postoperative VAS and incidence of lung infection(P<0.05).Conclusion Thoracoscopic anterior mediastinal tumor resection through subxiphoid process incision can significantly shorten the operation time and postoperative tube time,reduce operative pain,reduce postoperative drainage and postoperative complications of pulmonary infection,and promote postoperative recovery.

关 键 词：前纵隔肿瘤 胸腔镜 剑突下切口 肋间切口 

分 类 号：R654.2[医药卫生—外科学]