摘要
目的对比分析胸腔镜经剑突下与经肋间胸腺瘤切除术的临床疗效和安全性。方法纳入2015年1月至2019年3月于西安交通大学第一附属医院胸外科连续所行胸腔镜下胸腺瘤切除术患者124例,分为剑突下组47例,肋间组77例,对比分析两组临床特征及手术指标,术后疼痛评分、主要并发症情况和生活质量等。结果手术时间、术中出血量、术后肺炎、心律失常、膈神经麻痹、肌无力危象发生率两组间差异无统计学意义(P>0.05)。平均住院日:剑突下组低于肋间组(P<0.05)。疼痛评分:剑突下组术后第1天、第3天NRS伤口疼痛评分低于肋间组(P<0.05)。SF-36评分:剑突下组术后3个月及术后12个月评分高于肋间组(P<0.05)。结论胸腔镜经剑突下胸腺瘤切除术安全可行,与经肋间组相比,能明显减轻伤口疼痛,改善近期生活质量。
Objective To compare and analyze clinical efficacy and safety of subxiphoid vs.intercostal video-assisted thoracoscopic surgery(VATS)thymic tumor resection.Methods We selected 124 patients from January 2015 to March 2019,who received VATS thymic tumor resection in the Thoracic Department of The First Affiliated Hospital of Xi'an Jiaotong University.We divided them into the subxiphoid VATS group with 47 cases and intercostal VATS group with 77 cases to analyze clinical characteristics,postoperation outcomes,complications,pain score,and short-term quality of life.Results There were no significant differences in operation time,blood loss,the rate of postoperative pneumonia,arrhythmia,phrenic nerve paralysis or myasthenia crisis between the two groups(P>0.05).Average hospital stay:It was shorter in subxiphoid VATS group than intercostal VATS group(P<0.05).Pain score:It was lower the first day and the third day after operation in subxiphoid VATS group than in intercostal VATS group(P<0.05).SF-36 health scale score:3-month and 12-month postoperation score was higher in subxiphoid VATS group than in intercostal VATS group(P<0.05).Conclusion Subxiphoid VATS thymic tumor resection is safe and feasible;compared with intercostal approach,it can significantly reduce wound pain and improve short-term quality of life.
作者
贾卓奇
周维茹
李硕
李海军
张勇
张广健
付军科
JIA Zhuoqi;ZHOU Weiru;LI Shuo;LI Haijun;ZHANG Yong;ZHANG Guangjian;FU Junke(Department of Thoracic Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061;Department of Nuclear Medicine,Xi’an Gaoxin Hospital, Xi’an 710075, China)
出处
《西安交通大学学报（医学版）》
CAS
CSCD
北大核心
2021年第4期603-607,共5页
Journal of Xi’an Jiaotong University（Medical Sciences）
关键词
胸腺瘤
胸腔镜手术
经剑突下手术
重症肌无力
thymic tumor
video-assisted thoracoscopic surgery(VATS)
subxiphoid surgery
myasthenia gravis
