原发性前纵隔肿瘤应用胸腔镜手术微创治疗的临床疗效探讨  

Clinical Efficacy of Minimally Invasive Thoracoscopic Surgery for Primary Anterior Mediastinal Tumors

作　　者：李刚[1] 庞中好 顾添一 陈攻 郁珲[1] LI Gang;PANG Zhonghao;GU Tianyi;CHEN Gong;YU Hui(Department of Cardiothoracic Surgery,Affiliated Hospital of Jiangsu University,Zhenjiang,Jiangsu Province,212001 China)

机构地区：[1]江苏大学附属医院胸心外科,江苏镇江212001

出　　处：《世界复合医学》2022年第7期154-156,160,共4页World Journal of Complex Medicine

摘　　要：目的探讨对原发性前纵隔肿瘤患者采用胸腔镜手术微创方法治疗后获得的临床效果。方法选取2016年1月—2021年1月江苏大学附属医院收治的70例原发性前纵隔肿瘤患者,随机分为常规组(采用胸腔镜下经胸壁打孔手术治疗)和研究组(采用胸腔镜下经剑突下打孔手术治疗),各35例。比较两组患者治疗总有效率、术中、术后情况及使用镇痛药物比例。结果研究组治疗总有效率(94.29%)高于常规组(68.57%),差异有统计学意义(χ^(2)=7.652,P<0.05);研究组术中失血量、手术时间少于常规组,引流时间、住院时间均短于常规组,差异有统计学意义(P<0.05);两组患者肿瘤直径及总住院费用比较,差异无统计学意义(P>0.05);研究组术后镇痛药物使用比例(5.71%)低于常规组(34.29%),差异有统计学意义(P<0.05)。结论胸腔镜下经剑突下打孔手术方法有效应用,可显著提高治疗效果,有效改善术中及术后情况,显著降低镇痛药物使用比例,可提升原发性前纵隔肿瘤患者的预后水平。Objective To investigate the clinical effect of minimally invasive thoracoscopic surgery in patients with primary anterior mediastinal tumor.Methods A total of 70 patients with primary anterior mediastinal tumor who were admitted to Affiliated Hospital of Jiangsu University from January 2016 to January 2021 were selected for treatment research.They were randomly divided into the routine group(treated by thora⁃coscopic perforation through the chest wall)and the study group(with thoracoscopic perforation through the xiphoid process),with 35 cases in each group.The total effective rate,preoperative and postoperative conditions,and the proportion of analgesic drugs used in the two groups were compared.Results The total effective rate of treatment in the study group(94.29%)was higher than that in the routine group(68.57%),and the difference was statistically significant(χ^(2)=7.652,P<0.05).The intraoperative blood loss and operation time of the study group were re⁃spectively lower than those of the routine group,and the drainage time and the length of hospital stay were shorter than those of the routine group,and the differences was statistically significant(P<0.05).There was no statistically significant difference in tumor diameter and total hospitalization costs between the two groups(P>0.05).The proportion of postoperative analgesic drugs in the study group(5.71%)was lower than that in the routine group(34.29%),and the difference was statistically significant(P<0.05).Conclusion The effective application of thora⁃coscopic subxiphoid drilling can significantly improve the therapeutic effect,effectively improve the intraoperative and postoperative condi⁃tions,significantly reduce the proportion of analgesic drugs,and improve the prognosis of patients with primary anterior mediastinal tumors.

关 键 词：胸腔镜手术微创 原发性前纵隔肿瘤 打孔手术 

分 类 号：R734.5[医药卫生—肿瘤]