剑突下胸腔镜手术治疗胸腺瘤的临床疗效及其对术中出血量和术后并发症的影响。
Clinical efficacy of thoracoscopic surgery by subxiphoid approach for thymoma and its influence on intraoperative blood loss and postoperative complications.
作者信息
Shen Peng, Chen Quan, Zhu Fengwei, Tang Shouqi, Zhang Xuxian, Li Feng
机构信息
Department of Chest Surgery, Dongping Hospital Affiliated to Shandong First Medical University Dongping 271500, Shandong, China.
Department of Oncology, Dongping Hospital Affiliated to Shandong First Medical University Dongping 271500, Shandong, China.
出版信息
Am J Transl Res. 2021 Nov 15;13(11):12843-12851. eCollection 2021.
OBJECTIVE
To evaluate the clinical efficacy of thoracoscopic surgery by subxiphoid approach for patients with thymoma and its influence on intraoperative blood loss and postoperative complications.
METHODS
From January 2019 to January 2020, 90 patients who underwent thoracoscopic surgery were enrolled and evenly divided into a control group receiving surgery by lateral thoracic approach and an experimental group adopting the subxiphoid approach according to different surgical approaches, and their clinical data were retrospectively analyzed. The clinical efficacy, perioperative indexes, postoperative complications, pulmonary function, and inflammatory factors were compared between the two groups. Generic Quality of Life Inventory-74 (GQOLI-74) was used to assess the quality of life of the patients before and after surgery, and Mini-Mental State Examination (MMSE) was used to assess their mental state. The Numerical Rating Scale (NRS) was used to evaluate the postoperative pain of the two groups.
RESULTS
After treatment, the total clinical effectiveness rate of the experimental group was significantly higher than that of the control group (P<0.05). The experimental group obtained superior results in perioperative index and fewer postoperative complications compared with the control group (P<0.05). Better performance of FEV1 and FVC was observed in the experimental group than the control group (P<0.05). The experimental group had significantly higher postoperative GQOLI-74 scores (P<0.001) and MMSE scores (P<0.05) than the control group. Lower levels of C-reactive protein (CRP), and tumor necrosis factor-α (TNF-α), and lower NRS scores at 12 h and 24 h after surgery were witnessed in the experimental group compared to the control group (P<0.05).
CONCLUSION
For patients with thymoma, the thoracoscopic surgery by subxiphoid approach is safe and effective, and can reduce the intraoperative blood loss and postoperative complications.
目的
评估剑突下胸腔镜手术治疗胸腺瘤患者的临床疗效及其对术中出血量和术后并发症的影响。
方法
选取2019年1月至2020年1月行胸腔镜手术的90例患者，根据手术方式不同分为采用侧胸壁入路手术的对照组和采用剑突下入路的试验组，回顾性分析其临床资料。比较两组的临床疗效、围手术期指标、术后并发症、肺功能及炎症因子。采用生活质量综合评定问卷74（GQOLI-74）评估患者手术前后的生活质量，采用简易精神状态检查表（MMSE）评估其精神状态。采用数字分级量表（NRS）评估两组患者术后疼痛情况。
结果
治疗后，试验组的总临床有效率显著高于对照组（P<0.05）。试验组在围手术期指标方面优于对照组，术后并发症更少（P<0.05）。试验组的第1秒用力呼气容积（FEV1）和用力肺活量（FVC）表现优于对照组（P<0.05）。试验组术后GQOLI-74评分显著高于对照组（P<0.001），MMSE评分也高于对照组（P<0.05）。与对照组相比，试验组术后C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）水平更低，术后12 h和24 h的NRS评分更低（P<0.05）。
结论
对于胸腺瘤患者，剑突下胸腔镜手术安全有效，可减少术中出血量和术后并发症。
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