自主呼吸麻醉剑突入路单孔胸腔镜技术治疗胸腺瘤的临床研究  

Clinical study of single-port subxiphoid thoracoscopy under spontaneous breathing anesthesia for thymoma treatment

作　　者：罗金龙[1] 韦云萍 沈斌[1] 韦科全 孙振栋 于美钢[3] 蒋伟[1] 周一凡[1] LUO Jinlong;WEI Yunping;SHEN Bin;WEI Kequan;SUN Zhendong;YU Meigang;JIANG Wei;ZHOU Yifan(Department of Cardiothoracic Surgery,The People’s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,Guangxi,China;Graduate School,Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China;Department of Anesthesia,The People’s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,Guangxi,China)

机构地区：[1]广西壮族自治区人民医院心胸血管外科,广西南宁530021 [2]右江民族医学院研究生学院,广西百色533000 [3]广西壮族自治区人民医院麻醉科,广西南宁530021

出　　处：《右江民族医学院学报》2024年第4期543-546,552,共5页Journal of Youjiang Medical University for Nationalities

基　　金：南宁市青秀区科技计划项目合同(2020029)。

摘　　要：目的分析自主呼吸麻醉剑突入路单孔胸腔镜技术治疗胸腺瘤的临床价值。方法将本院心胸血管外科2021年3月至2023年3月42例诊断为胸腺瘤的患者纳入研究,按手术方式分为两组:自主呼吸麻醉剑突入路单孔胸腔镜组(A组,n=21)和双腔气管插管全麻侧胸胸腔镜组(B组,n=21)。比较两组围术期各项指标及随访情况。结果自主呼吸麻醉剑突入路单孔胸腔镜组在手术时间、术中失血量、术后引流管留置时间、术后引流量、术后住院时间和术后早期疼痛视觉模拟评分等方面均优于全麻侧胸胸腔镜组(P<0.05)。两组并发症和住院总费用比较差异无统计学意义(P>0.05)。随访显示,两组均未见肿瘤复发及转移。结论自主呼吸麻醉剑突入路单孔胸腔镜技术治疗胸腺瘤在较多方面优于全麻侧胸胸腔镜手术,安全性好,创伤小,术中出血少,术后疼痛轻、恢复快,不增加住院费用,值得临床进一步推广。Objective To analyze the clinical value of single-port subxiphoid thoracoscopy under spontaneous breathing anesthesia for thymoma treatment.Methods The study included 42 patients diagnosed with thymoma in the Department of Cardiothoracic Surgery from March 2021 to March 2023.Patients were divided into two groups according to surgical method:Group A(n=21)underwent single-port subxiphoid thoracoscopy under spontaneous breathing anesthesia,and Group B(n=21)underwent lateral thoracoscopy under general anesthesia with double-lumen tracheal intubation.Perioperative indicators and follow-up results were compared between the two groups.Results Group A showed superior outcomes compared to Group B in terms of operation time,intraoperative blood loss,postoperative drainage retain time,postoperative drainage volume,hospital stay after operation and early postoperative stage pain visual analogue score(P<0.05).There were no significant differences in complications and total hospitalization costs between the two groups(P>0.05).Follow-up showed no tumor recurrence or metastasis in either group.Conclusion Single-port subxiphoid thoracoscopy under spontaneous breathing anesthesia demonstrates several advantages over lateral thoracoscopy under general anesthesia for thymoma treatment.These include enhanced safety,less trauma,less intraoperative bleeding,milder postoperative pain,faster recovery,and comparable hospitalization costs,which is worthy of further clinical promotion.

关 键 词：自主呼吸麻醉 剑突入路 胸腔镜检查 胸腺瘤 

分 类 号：R736.3[医药卫生—肿瘤]