双拉钩胸骨抬高法在胸腔镜剑突下胸腺扩大切除术中的临床应用  

Clinical Application of Double Pull Hook Sternum Elevation Method in Thoracoscopic Subxiphoid Enlarged Thymectomy

作　　者：李祖设 张锡贵[1] 李汶珊[1] 倪武[1] 梁国连 LI Zushe;ZHANG Xigui;LI Wenshan;NI Wu;LIANG Guolian(Department of Thoracic Surgery,Guangdong Nongken Center Hospital,Zhanjiang,Guangdong Province,524002 China)

机构地区：[1]广东省农垦中心医院胸外科,广东湛江524002

出　　处：《系统医学》2024年第8期151-154,共4页Systems Medicine

基　　金：湛江市科技计划项目(2020B01180)。

摘　　要：目的分析胸腔镜剑突下胸腺扩大切除术中采取双拉钩胸骨抬高法的临床应用效果。方法选取广东省农垦中心医院于2021年2月—2022年2月收治的42例胸腺瘤伴重症肌无力患者为研究对象,由随机数表法分为两组,即参考组(常规入路方式实施胸腔镜剑突下胸腺扩大切除手术)21例、研究组(参考组的基础上实施双拉钩胸骨抬高方案)21例,对比两组效果、手术操作时间、术后发生并发症情况。结果研究组治疗有效率为95.24%,高于参考组的90.48%,但差异无统计学意义(χ^(2)=0.000,P>0.05);研究组手术相关指标优于参考组,差异有统计学意义(P均<0.05)。研究组并发症发生率为4.76%,低于参考组,差异有统计学意义(P<0.05)。结论以双拉钩胸骨抬高方案辅助胸腕镜剑突下胸腺扩大切除手术治疗胸腺瘤伴重症肌无力患者时,手术视野扩大,手术操作的空间拓展,手术时间缩减,不会给机体带来较大创伤,手术成功率、安全性良好。Objective To analyze the clinical application effect of adopting double pull hook sternum elevation method in thoracoscopic subxiphoid enlarged thymectomy.Methods A total of 42 patients with thymoma and myasthenia gravis admitted to the Department of Thoracic Surgery of Guangdong Nongken Center Hospital from February 2021 to February 2022 were selected as the research objects.They were divided into two groups by random number table method,21 cases in the reference group(thoracoscopic subxiphoid thymectomy was performed by conventional approach)and 21 cases in the study group(double-hook sternal elevation scheme was implemented on the basis of the reference group).The effects,operation time and postoperative complications of the two groups were compared.Results The effective rate of treatment in the study group was 95.24%,which was higher than 90.48%in the reference group,but the difference was not statistically significant(χ^(2)=0.000,P>0.05).The operation related indexes of the study group were better than those of the reference group,and the differences were statistically significant(all P<0.05).The incidence of complications in the study group was 4.76%,which was lower than that in the reference group,the difference was statistically significant(P<0.05).Conclusion When the double pull hook sternum elevation program is used to assist thoracoscopic subxiphoid enlarged thymectomy for the treatment of thymoma with myasthenia gravis,the surgical field is enlarged,the space for surgical operation is expanded,the operating time is reduced,and it will not bring large trauma to the body,and the surgical success rate and safety are very high.

关 键 词：双拉钩胸骨抬高法 胸腔镜 剑突下胸腺 扩大切除术 治疗有效率 手术时间 并发症 

分 类 号：R655[医药卫生—外科学]