经剑突下与经侧胸入路胸腔镜手术治疗对前纵隔肿瘤患者围术期指标的影响  

Effect of Thoracoscopic Surgery Via Subxiphoid and Transthoracic Approach on Perioperative Indicators of Patients with Anterior Mediastinal Tumors

作　　者：程韬 杨秀华 龙建军 陈健 田承浩 李其中 CHEN Tao;YANG Xiuhua;LONG Jianjun;CHEN Jian;TIAN Chenghao;LI Qizhong(Department of Thoracic Cardiovascular Surgery,Qiandongnan People's Hospital,Kaili 556000,China)

机构地区：[1]黔东南州人民医院胸外心脏大血管外科,贵州凯里556000

出　　处：《反射疗法与康复医学》2024年第22期130-133,共4页Reflexology And Rehabilitation Medicine

摘　　要：目的探讨经剑突下与经侧胸入路胸腔镜手术治疗前纵隔肿瘤的临床效果。方法回顾性分析2021年6月—2024年6月于黔东南州人民医院行前纵隔肿瘤切除术的60例患者的临床资料,根据手术方式的不同将其分为对照组和观察组,各30例。对照组行经侧胸入路胸腔镜切除术,观察组行经剑突下入路胸腔镜切除术。对比两组的围术期指标、术后疼痛程度、炎症因子水平及并发症发生情况。结果观察组术后引流量为(152.68±12.51)mL,少于对照组的(254.63±28.69)mL,术后拔管时间、住院时间分别为(3.25±0.41)d、(7.41±1.25)d,均短于对照组的(4.25±0.48)d、(8.65±1.32)d,组间差异有统计学意义(P<0.05)。术后12 h、24 h,观察组疼痛视觉模拟评分分别为(3.24±0.36)分、(2.23±0.25)分,均低于对照组的(4.12±0.45)分、(3.05±0.34)分,组间差异有统计学意义(P<0.05);术后24 h,观察组白细胞计数、C反应蛋白水平均低于对照组,组间差异有统计学意义(P<0.05)。观察组并发症发生率为6.67%,低于对照组的26.67%,差异有统计学意义(P<0.05)。结论经剑突下入路胸腔镜切除术治疗前纵隔肿瘤患者,术后疼痛程度较轻,炎症因子水平更低,且并发症少,值得推广应用。。Objective To investigate the clinical effect of thoracoscopic surgery with subxiphoid and lateral thoracoscopic approach in the treatment of anterior mediastinal tumors.Methods The clinical data of 60 patients with anterior mediastinal tumor resection admitted to Qiandongnan People's Hospital from June 2021 to June 2024 were retrospectively analyzed,according to different operation methods,they were divided into a control group and an observation group,with 30 cases in each group.The control group underwent thoracoscopic resection through lateral thoracic approach,and the observation group underwent thoracoscopic resection through subxiphoid approach.The perioperative indicators,postoperative pain,inflammatory factors and complications were compared between the two groups.Results The postoperative drainage volume of the observation group was(152.68±12.51)mL,which was less than(254.63±28.69)mL of the control group,the postoperative extubation time and hospitalization time were(3.25±0.41)d and(7.41±1.25)d,which were shorter than(4.25±0.48)d and(8.65±1.32)d of the control group,the differences between the groups were statistically significant(P<0.05).At 12 hours and 24 hours after operation,the pain Visual Analogue Scale scores of the observation group were(3.24±0.36)points and(2.23±0.25)points,respectively,which were lower than(4.12±0.45)points and(3.05±0.34)points of the control group,and the differences between the groups were statistically significant(P<0.05);24 hours after operation,the white blood cell and C-reactive protein level in the observation group were lower than those in the control group, and the differences between the groups were statistically significant (P<0.05). The incidence of complications in the observation group was 6.67%, which was lower than 26.67% in the control group, and the difference was statistically significant (P<0.05). Conclusion For patients with anterior mediastinal tumors, the thoracoscopic resection via the subxiphoid approach can result in less postoperative pain,

关 键 词：前纵隔肿瘤切除术 经剑突下入路 经侧胸入路 围术期指标 应激反应 

分 类 号：R734.5[医药卫生—肿瘤]