前纵隔占位与左无名静脉位置关系对胸腔镜手术的影响  

The Influence of the Relationship Between Anterior Mediastinal Mass and the Position of the Left Unnamed Vein on Thoracoscopic Surgery

作　　者：李铁钊 姜天烁 赵学飞 苏志勇 LI Tiezhao;JIANG Tianshuo;ZHAO Xuefei;SU Zhiyong(Inner Mongolia University of Science and Technology Baotou Medical College,Baotou 014010 China;Chifeng College Affiliated Hospital,Chifeng 024000 China)

机构地区：[1]内蒙古科技大学包头医学院,内蒙古包头014010 [2]赤峰学院附属医院,内蒙古赤峰024000

出　　处：《内蒙古医学杂志》2024年第5期518-524,共7页Inner Mongolia Medical Journal

基　　金：内蒙古自治区自然科学基金(编号:2020MS08087);赤峰市区域协同创新平台科技合作项目(编号:2022sj001)。

摘　　要：目的本研究旨在探索前纵隔占位与左无名静脉(LBCV)位置关系对胸腔镜手术的影响。方法回顾性分析60例行胸腔镜手术(VATS)的前纵隔占位患者,查询术前增强CT,测量前纵隔占位手术操作空间的变量a、b、c、d和前纵隔占位与左无名静脉位置关系的变量A、B、C,对其与胸腔镜手术的相关性进行分析。结果卡方检验(χ^(2) test)显示占位完全包绕下,不同术式之间差异具有统计学意义(P=0.001)。Spearman相关分析显示,变量a与手术时间、术中出血量、术后带管时间、住院总时间呈负相关;变量b与手术时间、术中出血量、术后带管时间呈负相关;变量c与手术时间呈负相关;变量d与手术时间、术中出血量呈负相关。F检验分析结果显示,前纵隔占位的3种类型在手术时间、术中出血量、术后带管时间的表现上差异具有统计学意义(P<0.05)。结论前纵隔占位与左无名静脉的位置关系可能会影响胸腔镜手术的术式,仰卧位胸腔镜下右胸辅助胸骨上窝、剑突下胸骨拉钩入路为前纵隔占位手术提供了更大的手术操作空间,且多用于占位完全包绕左无名静脉的患者中;手术时间、术中出血量、术后带管时间与前纵隔占位的手术操作空间呈负相关。Objective The aim of this study was to explore the impact of anterior mediastinal occupancy in relation to the position of the left brochiocephalic vein(LBCV)on thoracoscopic surgery.Methods Sixty patients with anterior mediastinal occupancy who underwent thoracoscopic surgery(VATS)were retrospectively analysed,and preoperative enhanced CT was queried to measure the variables a,b,c,and d of surgical operating space of anterior mediastinal occupancy and the variables A,B,and C of the relationship between the position of the anterior mediastinal occupancy and the left innominate vein in relation to the thoracoscopic operation was analysed.Results The χ^(2) test showed statistical significance between different surgical procedures under complete encompassment of the occupying space(P=0.001).Spearman's correlation analysis showed a negative correlation between variable a and operative time,intraoperative haemorrhage,postoperative time with tubes,and total hospital stay;a negative correlation between variable b and operative time,intraoperative haemorrhage,and postoperative time with tubes;a negative correlation between variable c and operative time;and a variable d was negatively correlated with operative time and intraoperative bleeding;F-test analysis showed that the three types of anterior mediastinal occupations showed significant differences in the performance of operative time,intraoperative bleeding,and postoperative banding time(P<0.05).Conclusion The positional relationship between the anterior mediastinal space and the left innominate vein may affect the thoracoscopic surgical procedure.The suprasternal fossa of the right thoracic assisted sternum and the subxiphoid sternal hook approach under thoracoscopy in the supine position provide greater surgical operation space for the anterior mediastinal space and are mostly used in the patients with a space that completely encompasses the left innominate vein;the surgical time,the amount of intraoperative bleeding,and the time of post-operative tube carrying wer

关 键 词：左无名静脉 前纵隔占位 胸腔镜 

分 类 号：R734.4[医药卫生—肿瘤]