摘要
目的观察电视胸腔镜辅助小切口治疗肺癌的疗效,并与传统开胸手术进行比较,探讨两种术式对凝血功能的影响。方法回顾分析62例肺癌患者,分为胸腔镜组32例和对照组(传统开胸手术)30例,比较两组手术疗效及术后并发症的发生率,同时比较两组的凝血指标PT、APTT、PLT、DD的变化。结果胸腔镜组的手术时间、引流时间及住院时间明显短于对照组,术中出血量也明显少于对照组(P<0.05或P<0.01)。两组术前PT、APTT、PLT、DD分别比较,差异无显著性;术后7d检测发现,两组PT均延长,APTT缩短,PLT明显降低,而DD明显升高,与术前比较有统计学意义(P<0.05),而对照组的PT、APTT、PLT、DD变化较胸腔镜组更为显著(P<0.05)。胸腔镜组术后并发症的发生率明显低于对照组。结论胸腔镜辅助小切口手术具有比传统开胸术损伤小,血栓栓塞的并发症发生率低的优点,且对患者的凝血功能影响较小,在肺癌手术治疗中值得推广。
Objective To investigate the small-incision VATS treatment of lung cancer and compare with traditional open heart surgery and further explore the effects of two procedures on blood coagulation. Methods Sixty-two cases of lung cancer were randomly divided into 32 cases of thoracoscopic group and 30 cases of control group （traditional open heart surgery）, and the surgery and postoperative complication rate and the changes in the coagulation indexes PT,APTT,PLT and DD were compared between the two groups. Results The operative time, drainage time and hospital stay in the thoracoscopic group were shorter than those in the control group and the blood loss of the former was less than that of the latter （P〈0.05 or P〈0.01）. There were no significant differences in preoperative PT,APTT,PLT and DD between the two groups, and both groups showed extended PT, shortened APTT, significantly decreased PLT and significantly increased DD 7d after post-operation, with a significant difference between pre-operation and post-operation （P〈0.05）, and there were significant changes in PT, APTT,PLT and DD in the control group compared with the thoracoscopic group （P〈0.05）. The complications of the thoracoscopic group was significantly fewer than those of the control group. Conclusion Video-assisted thoracoscopie small incision surgery has less damage than traditional open heart surgery, a low incidence of thromboembolic complications and less impact on coagulation in small lung cancer.
出处
《中国现代医生》
2010年第23期1-2,7,共3页
China Modern Doctor
关键词
电视胸腔镜(VATS)
小切口
肺癌
凝血功能
Video-assisted thoracoscopic （VATS）
Small incision
Lung cancer
Blood coagulation
