电视胸腔镜下纵膈肿瘤切除术对纵膈肿瘤患者手术指标术后恢复和预后的影响
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摘要
目的:分析探讨电视胸腔镜下纵膈肿瘤切除术对纵膈肿瘤患者手术指标、术后恢复和预后的影响。方法:选取我院于2013年6月至2018年6月期间收治的60例纵隔肿瘤患者,按照随机数字表法将所有患者简单随机分为对照组和试验组两组,其中试验组患者均在电视胸腔镜下采取纵隔肿瘤切除术进行治疗,而对照组患者则按照常规采取标准开胸手术进行治疗,观察两组患者在手术中的相关指标和术后恢复的相关指标,比较两组患者的术后并发症发生率。结果:两组患者的总手术时间并无明显差异(P>0.05);试验组患者的开胸时间、开胸出血量以及关胸时间分别为(12.07±3.27) min、(13.26±4.33) mL、(11.09±2.14) min;均显著低于对照组患者(18.20±2.34) min、(24.98±8.43) mL、(21.09±3.28) min(t=5.323,t=5.293,t=4.985,均P <0.05)。试验组患者的术后带管时间和术后引流量、术后住院时间分别为(3.09±0.89) d、(354.45±101.22) mL、(7.15±2.35) d;均显著低于对照组的(5.59±1.23) d、(643.34±144.20) mL、(10.98±3.17) d(t=4.593,t=5.045,t=4.475,均P<0.05)。对照组患者中有8例患者出现术后并发症,而试验组中只有3例患者出现术后并发症,试验组患者的术后并发症发生率为10.00%,显著低于对照组患者的26.67%(χ~2=8.374,P <0.05)。结论:对纵膈肿瘤患者采取电视胸腔镜下纵隔肿瘤切除术能够有效减少对患者的创伤,大大缩短了患者术后恢复时间,临床疗效高且术后并发症少,值得在临床上加以推广运用。
Objective: To investigate the effect of video-assisted thoracoscopic resection of mediastinal tumor on surgical parameters,postoperative recovery and prognosis in patients with mediastinal tumor. Methods: 60 patients with mediastinal tumors admitted to our hospital from June 2013 to June 2018 were randomly divided into control group and experimental group according to random number table method. The experimental group was treated with mediastinal tumors resection under video-assisted thoracoscopy,while the control group was treated with standard thoracotomy. Relevant indexes of operation and recovery were observed,and the incidence of postoperative complications was compared between the two groups. Results: There was no significant difference in the total operation time between the two groups (P >0. 05),the time of thoracotomy,the amount of bleeding and the time of closure were (12.07±3.27) min, (13.26±4.33) ml, (11.09±2.14) min;,respectively,which were significantly lower than those in the control group (18.20 ± 2.34) min, (24.98 ± 8.43) ml, (21.09±3.28) min (t = 5.323,t = 5.293,t = 4.985,P < 0. 05). Postoperative time of tubing in the trial group The postoperative hospitalization time was (3.09 ± 0.89) d, (354.45 ± 101.22) ml, (7. 15 ± 2. 35)days,which was significantly lower than that in the control group (5.59 ±1.23) d, (643.34 ± 144.20) ml, (10.98±3.17) d (t= 5.045,P<0.05). In the control group,8 patients had postoperative complications,while in the trial group,only 3 patients had postoperative complications. The incidence of postoperative complications in the trial group was as follows: 10.00% was significantly lower than that in the control group 26.67% (χ~2= 8.374,P <0.05). Conclusion: Video-assisted thoracoscopic resection of mediastinal tumors can effectively reduce the trauma,shorten the time of postoperative recovery,and have a high clinical effect and few postoperative complications,so it is worth popularizing and applying in clinic.
Objective: To investigate the effect of video-assisted thoracoscopic resection of mediastinal tumor on surgical parameters,postoperative recovery and prognosis in patients with mediastinal tumor. Methods: 60 patients with mediastinal tumors admitted to our hospital from June 2013 to June 2018 were randomly divided into control group and experimental group according to random number table method. The experimental group was treated with mediastinal tumors resection under video-assisted thoracoscopy,while the control group was treated with standard thoracotomy. Relevant indexes of operation and recovery were observed,and the incidence of postoperative complications was compared between the two groups. Results: There was no significant difference in the total operation time between the two groups (P >0. 05),the time of thoracotomy,the amount of bleeding and the time of closure were (12.07±3.27) min, (13.26±4.33) ml, (11.09±2.14) min;,respectively,which were significantly lower than those in the control group (18.20 ± 2.34) min, (24.98 ± 8.43) ml, (21.09±3.28) min (t = 5.323,t = 5.293,t = 4.985,P < 0. 05). Postoperative time of tubing in the trial group The postoperative hospitalization time was (3.09 ± 0.89) d, (354.45 ± 101.22) ml, (7. 15 ± 2. 35)days,which was significantly lower than that in the control group (5.59 ±1.23) d, (643.34 ± 144.20) ml, (10.98±3.17) d (t= 5.045,P<0.05). In the control group,8 patients had postoperative complications,while in the trial group,only 3 patients had postoperative complications. The incidence of postoperative complications in the trial group was as follows: 10.00% was significantly lower than that in the control group 26.67% (χ~2= 8.374,P <0.05). Conclusion: Video-assisted thoracoscopic resection of mediastinal tumors can effectively reduce the trauma,shorten the time of postoperative recovery,and have a high clinical effect and few postoperative complications,so it is worth popularizing and applying in clinic.
引文
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[2]陈楠,张莹,郭刚,等.微创胸腔镜下纵膈切除术治疗纵隔肿瘤的疗效[J].河北医学,2016,22(2):201~204.
[3]Booka E,Kitano M,Nakano Y,et al.Life-threatening giant esophageal neurofibroma with severe tracheal stenosis:a case report[J].Surg Case Rep,2018,4(1):107.
[4]Yang D,Zhou Y,Wang W.Total thoracoscopic high-position sleeve lobectomy of the right upper lobe of the lung[J].J Thorac Dis,2018,10(7):4490~4497.
[5]Pan Q,Wang Y,Luo Y,et al.Hepatic involvement of Ig G4-related disease presenting as multiple hypermetabolic masses on FDG PET/CT[J].Clin Nucl Med,2018,43(10):777~779.
[6]周伟,张大发,聂军,等.单孔胸腔镜手术切除纵隔肿瘤25例[J].皖南医学院学报,2017,36(6):564~566.
[7]王国海,何理祥,郭圣聪,等.电视胸腔镜肺癌根治术与常规肺癌根治术淋巴结清扫效果对比分析[J].中国基层医药,2017,24(9):1329~1332.
[8]Ju L,Han M,Su J,et al.A lung squamous carcinoma patient with ROS1 rearrangement sensitive to crizotinib[J].Cancer Chemother Pharmacol,2018,82(3):561~564.
[9]Koyama S,Fujiwara K,Nosaka K,et al.Immunohistochemical features of primary pure squamous cell carcinoma in the thyroid:an autopsy case[J].Case Rep Oncol,2018,11(2):418~424.
[10]唐兴,张晨,何靖康,等.单孔与双孔胸腔镜手术切除后纵隔肿瘤的对比研究[J].中国血液流变学杂志,2017,27(3):298~300.