剑突下与右胸入路全胸腔镜胸腺扩大切除疗效对比  

Comparison of the Effect of Subxiphoid and Right Thoracic Approach Total Video-assisted Thoracoscopic Extended Thymectomy

作　　者：高建利 张奕 张文山 陈定柱 黄镇 GAO Jianli;ZHANG Yi;ZHANG Wenshan;CHEN Dingzhu;HUANG Zhen(Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou 363000,China;不详)

机构地区：[1]福建医科大学附属漳州市医院,福建漳州363000

出　　处：《中国医学创新》2023年第23期24-28,共5页Medical Innovation of China

摘　　要：目的:观察全胸腔镜胸腺扩大切除术(video-assisted thoracoscopic extended thymectomy,VATET)选择剑突下与右胸入路的临床疗效差异。方法:选取324例福建医科大学附属漳州市医院于2020年1月—2022年5月接收的全VATET患者,按随机数字表法分组,观察组162例患者选取经剑突下入路,对照组162例患者选取右胸入路,对比两组临床疗效。结果:观察组的手术时间短于对照组,术中出血量少于对照组,差异均有统计学意义(t=3.503、2.725,P<0.05)。两组患者的术后住院时间及引流管留置时间比较差异均无统计学意义(P>0.05)。观察组术后1、3、7 d的视觉模拟评分法(VAS)评分均低于对照组,差异均有统计学意义(t=35.997、27.782、9.150,P<0.05)。两组术后并发症发生率比较差异无统计学意义(P>0.05)。两组术后有效率及胸腺瘤复发率比较差异均无统计学意义(P>0.05)。结论:在全VATET术中选择剑突下与右胸入路均可取得显著疗效,但剑突下入路可减少手术时间、术中出血量,减轻患者疼痛。Objective:To observe the difference of clinical effect between subxiphod and right thoracic approach in total video-assisted thoracoscopic extended thymectomy(VATET).Method:A total of 324 total VATET cases from Zhangzhou Affiliated Hospital of Fujian Medical University from January 2020 to May 2022 were selected,according to the random number table method,162 patients in the observation group were selected through the subxiphoid approach,162 patients in the control group were selected through the right thoracic approach,and the clinical efficacy of the two groups was compared.Result:The operation time of observation group was shorter than that of control group,and the amount of bleeding during operation was less than that of control group,the differences were statistically significant(t=3.503,2.725,P<0.05).There were no significant differences in postoperative hospitalization and drainage tube retention time between the two groups of patients(P>0.05).The visual analogue scale(VAS)scores of the observation group were lower than those of the control group 1,3 and 7 days after operation,the differences were statistically significant(t=35.997,27.782,9.150,P<0.05).There was no significant difference in postoperative complications between the two groups(P>0.05).There were no significant differences in the postoperative effective rate and recurrence rate of thymoma between the two groups(P>0.05).Conclusion:In total lVATET surgery,both the subxiphoid and right thoracic approaches can achieve significant therapeutic effects,but the subxiphoid approach can reduce surgical time,intraoperative bleeding,and alleviate patient pain.

关 键 词：剑突下入路 右胸入路 全胸腔镜 胸腺扩大切除术 

分 类 号：R736.3[医药卫生—肿瘤]