两种不同入路胸腔镜胸腺切除术治疗前纵隔肿瘤的疗效观察  

Efficacy observation of thoracoscopic thymectomy via two different approaches for anterior mediastinal tumor

作　　者：李爽 李伟 魏在日 LI Shuang;LI Wei;WEI Zai-ri(Thoracic Surgery Department,Yingkou Fangda Hospital Co.,Ltd.,Yingkou 115000,China)

机构地区：[1]营口方大医院有限公司胸外科,115000

出　　处：《中国实用医药》2024年第20期53-56,共4页China Practical Medicine

摘　　要：目的探讨两种不同入路胸腔镜胸腺切除术治疗前纵隔肿瘤的疗效。方法157例前纵隔肿瘤患者,按照随机数字表法分为对照组(78例)、观察组(79例)。对照组给予经肋间入路胸腔镜胸腺切除术治疗,观察组给予经剑突入路胸腔镜胸腺切除术治疗。比较两组手术相关指标、炎症指标、术后并发症发生情况。结果观察组手术时间(72.48±12.32)min、留置引流管时间(1.32±0.45)d均较对照组的(98.56±13.45)min、(2.56±0.62)d短,术中出血量(28.56±3.51)ml、术后引流量(192.51±21.35)ml均较对照组的(46.25±6.25)、(265.36±32.51)ml少(P<0.05)。术前1 d,两组白细胞计数(WBC)、C反应蛋白(CRP)比较无显著差异(P>0.05);术后1 d,两组WBC、CRP均较术前1 d升高,观察组WBC(8.56±1.42)×10^(9)/L、CRP(8.62±1.32)mg/L较对照组的(10.62±1.51)×10^(9)/L、(11.52±1.65)mg/L低(P<0.05)。观察组术后并发症发生率(5.06%)较对照组(15.38%)低(P<0.05)。结论相对于经肋间入路胸腔镜胸腺切除术治疗,经剑突入路胸腔镜胸腺切除术更有助于缩短前纵隔肿瘤患者的手术时间、留置引流管时间,减少术中出血量及术后引流量,减轻炎症反应,且术后并发症也更少。Objective To explore the efficacy of thoracoscopic thymectomy via two different approaches for anterior mediastinal tumor.Methods A total of 157 patients with anterior mediastinal tumor were divided into a control group(78 cases)and an observation group(79 cases)according to random number table method.The control group received thoracoscopic thymotomy via intercostal approach,while the observation group received thoracoscopic thymotomy via xiphoid approach.The operation related indexes,inflammation markers and postoperative complications were compared between the two groups.Results In the observation group,the operation time was(72.48±12.32)min and the catheter retention time was(1.32±0.45)d,which were shorter than(98.56±13.45)min and(2.56±0.62)d in the control group;the amount of intraoperative blood loss was(28.56±3.51)ml and the postoperative drainage volume was(192.51±21.35)ml,which were lower than(46.25±6.25)and(265.36±32.51)ml in the control group(P<0.05).1 d before surgery,there were no significant differences in white blood cell count(WBC)and C-reactive protein(CRP)between the two groups(P>0.05).1 d after surgery,WBC and CRP in both groups were higher than those 1 d before surgery;the observation group had WBC of(8.56±1.42)×10^(9)/L and CRP of(8.62±1.32)mg/L,which were lower than(10.62±1.51)×10^(9)/L and(11.52±1.65)mg/L in the control group(P<0.05).The incidence of postoperative complications in the observation group(5.06%)was lower than that in the control group(15.38%)(P<0.05).Conclusion Compared with thoracoscopic thymectomy via intercostal approach,transxiphoid approach is more helpful to shorten the operation time and catheter retention time of patients with anterior mediastinal tumor,reduce the amount of intraoperative blood loss and postoperative drainage volume,alleviate inflammatory reaction and reduce the occurrence of postoperative complications.

关 键 词：经肋间入路 经剑突入路 胸腔镜 胸腺切除术 前纵隔肿瘤 炎症水平 

分 类 号：R734.5[医药卫生—肿瘤]