摘要
目的观察剑突下单孔胸腔镜前纵膈肿瘤切除的近远期疗效。方法选取2016年6月至2017年6月于咸阳市第一人民医院心胸大血管外科行手术治疗的76例原发性前纵膈肿瘤患者为研究对象,采用区组随机化法将其分为观察组和对照组,每组38例。观察组采用剑突下单孔胸腔镜肿瘤切除术治疗,对照组采用开胸肿瘤切除术治疗。比较两组患者的术后疗效、手术指标、手术前后的血浆皮质醇(Cr)、促肾上腺皮质激素(ACTH)水平、视觉模拟评分(VAS)及并发症发生情况。结果观察组患者的临床缓解率为94.74%,明显高于对照组的78.95%,差异有统计学意义(P<0.05);观察组患者的术后并发症总发生率为7.89%,明显低于对照组的26.32%,差异有统计学意义(P<0.05);观察组患者的手术时间、术后引流时间、住院时间分别为(85.17±7.46)min、(2.85±0.41)d、(9.16±1.19)d,明显短于对照组的(98.52±8.90)min、(4.10±0.53)d、(10.23±1.24)d,术中出血量为(38.68±6.09)mL,明显少于对照组的(69.73±7.18)mL,差异均有统计学意义(P<0.05);观察组患者术后1周的VAS评分为(3.72±0.63)分,明显低于对照组的(4.17±0.71)分,术后1周的Cr、ACTH水平分别为(128.14±12.83)ng/mL、(3.89±0.35)ng/mL,明显高于对照组的(119.09±11.63)ng/mL、(3.62±0.31)ng/mL,差异均有统计学意义(P<0.05);观察组和对照组患者术后3年的生存率分别为78.95%、65.79%,差异无统计学意义(P>0.05)。结论剑突下单孔胸腔镜切除术治疗原发性前纵膈肿瘤可缩短手术时间及住院时间,减轻术后应激反应,且术后并发症少于开胸肿瘤切除术,其近期疗效较好,但其远期疗效与开胸肿瘤切除术治疗无较大差异。
Objective To explore the short-term and long-term effects of single-hole thoracoscopic anterior mediastinum tumor resection under xiphoid process.Methods Seventy-six patients with primary anterior mediastinum tumors who underwent surgery in Department of Cardiothoracic and Macrovascular Surgery,the First People's Hospital of Xianyang from June 2016 to June 2017 were enrolled as the research objects.They were divided into observation group(single-hole thoracoscopic tumor resection under xiphoid process)and control group(open surgery)by block randomization method,with 38 cases in each group.The levels of plasma cortisol(Cr)and adrenocorticotropic hormone(ACTH)before and after surgery,scores of Visual Analogue Scale(VAS),postoperative curative effect,and complications were compared between the two groups.Results The clinical remission rate in observation group was 94.74%,which was significantly higher than 78.95%in control group(P<0.05).The incidence of postoperative complications in observation group was 7.89%,which was significantly lower than 26.32%in control group(P<0.05).The operation time,postoperative drainage time,and hospitalization time in observation group were(85.17±7.46)min,(2.85±0.41)d,and(9.16±1.19)d,which was significantly shorter than(98.52±8.90)min,(4.10±0.53)d,and(10.23±1.24)d in control group,and intraoperative blood loss was(38.68±6.09)mL,significantly less than(69.73±7.18)mL in the control group(P<0.05).At 1 week after surgery,VAS score in observation group was lower than that in control group:(3.72±0.63)points vs(4.17±0.71)points,while levels of Cr and ACTH were higher than those in control group:(128.14±12.83)ng/mL vs(119.09±11.63)ng/mL,(3.89±0.35)ng/mL vs(3.62±0.31)ng/mL(P<0.05).The survival rates at 3 years after surgery in observation group and control group were 78.95%and 65.79%(P>0.05).Conclusion The short-term curative effect of single-hole thoracoscopic resection under xiphoid process is good on primary anterior mediastinum tumors,which can shorten operation time and hosp
作者
胡艳正
石鹏飞
HU Yan-zheng;SHI Peng-fei(Department of Cardiothoracic and Macrovascular Surgery,the First People's Hospital of Xianyang,Xianyang 712000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2021年第1期64-67,共4页
Hainan Medical Journal
关键词
前纵膈肿瘤
剑突
单孔胸腔镜
手术疗效
预后
Anterior mediastinum tumor
Xiphoid process
Single-hole thoracoscope
Surgical curative effect
Prognosis
