胸腔镜经剑突下与经肋间入路纵隔肿物切除术疗效比较  

Comparison of efficacy of thoracoscopic resection of mediastinal masses by subxiphoid and intercostal approach

作　　者：李博 侯宇琦 许世广 王述民 LI Bo;HOU Yu-qi;XU Shi-guang;WANG Shu-min(Department of Thoracic Surgery,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]北部战区总医院胸外科,辽宁沈阳110016

出　　处：《临床军医杂志》2024年第4期378-380,385,共4页Clinical Journal of Medical Officers

基　　金：辽宁省博士科研启动基金(2021-BS-033)。

摘　　要：目的比较胸腔镜经剑突下与经肋间入路纵隔肿物切除术的疗效。方法选取北部战区总医院自2021年至2022年6月收治的79例行纵隔肿物切除术患者为研究对象。根据不同的入路方式将患者分为A组(n=27)与B组(n=52)。A组患者采用经剑突下入路方式,B组患者采用经肋间入路方式。记录所有患者的术后病理结果。收集并比较两组患者术中、术后相关指标及不良反应发生情况。分别于术后第1天、术后第2天、术后第2个月,记录并比较两组患者的疼痛视觉模拟评分(VAS)。结果两组患者术中出血量、术后胸引量、带管时间、术后住院时间比较,差异均无统计学意义(P>0.05);A组患者手术时间长于B组,差异有统计学意义(P<0.05)。A组患者术后第1天、术后第2天、术后第2个月的VAS评分均高于B组,差异有统计学意义(P<0.05)。A组、B组患者不良反应发生率分别为7.41%(2/27)、7.69%(4/52),差异无统计学意义(P>0.05)。结论与经剑突下入路方式比较,经肋间入路纵隔肿物切除术的优势在于手术时间更短、术后疼痛程度更轻。Objective To compare the efficacy of thoracoscopic resection of mediastinal masses by subxiphoid and intercostal approach.Methods 79 patients with mediastinal mass resection admitted to General Hospital of Northern Theater Command from 2021 to June 2022 were selected as the study objects.Patients were divided into group A(n=27)and group B(n=52)according to different approaches.Subxiphoid approach was adopted in group A and transcostal approach was adopted in group B.The postoperative pathological results of all patients were recorded.The intraoperative and postoperative indexes and the occurrence of adverse reactions were collected and compared between the two groups.Visual analogue score(VAS)of the two groups were recorded and compared the 1st day,2nd day and 2nd month postoperative days respectively.Results There were no significant differences in intraoperative blood loss,postoperative chest catheterization,catheter time and postoperative hospital stay between the two groups(P>0.05).The operation time of group A was longer than that of group B,and the difference was statistically significant(P<0.05).The VAS of group A on the 1st day,2nd day and 2nd month after surgery were higher than those of group B,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in group A and group B was 7.41%(2/27)and 7.69%(4/52),respectively,with no statistical significance(P>0.05).Conclusion Compared with subxiphoid approach,transcostal approach for mediastinal mass resection has the advantages of shorter operation time and less postoperative pain.

关 键 词：剑突下 肋间 胸腔镜 纵隔肿物 

分 类 号：R655.5[医药卫生—外科学]