电视胸腔镜下经胸径胸腺切除术与胸骨正中切开胸腺切除术治疗重症肌无力的临床随机对照研究

目的对比观察电视胸腔镜下经胸径胸腺切除术与胸骨正中切开胸腺切除术治疗重症肌无力的疗效。方法选择重症肌无力患者,随机分为给予电视胸腔镜下经胸径胸腺切除术治疗的观察组和胸骨正中切开胸腺切除术治疗的对照组,观察手术相关指标及应激状态指标。结果观察组的手术时间、术中出血量、术后机械通气时间、ICU监护时间、伤口引流量、重症肌无力危象发生例数、镇痛药物使用例数、术后卧床总时间、血糖水平、汉密尔顿焦虑自评量表(HAMA)评分、汉密尔顿抑郁自评量表(HAMD)评分、数字评估量表(NRS)评分均低于对照组,血胰岛素水平高于对照组(P0.05)。结论电视胸腔镜下经胸径胸腺切除术能减小手术创伤、促进术后恢复、缓解应激状态,具有积极的临床价值。

RCT of video - assisted thoracoscopic thymectomy and trans - sternal thymectomy in treating myasthenia gravis

Objective To study the effect of video - assisted thoracoscopic thymectomy and trans - sternal thymectomy in treating myasthenia gravis. Methods Myasthenia gravis patients were enrolled and randomly divided into observation group given video - assisted thoracoscopic thymectomy and control group given trans - sternal thymectomy. Then operation related index and stress state index were observed. Results Operation time, bleeding volume, postoperative mechanical ventilation time, ICU monitoring time, wound drainage volume, myasthenia gravis crisis ca- ses, analgesic drug use cases, postoperative bed time and blood glucose level, HAMA, HAMD, NRS of observation group were less than control group ; the serum insulin level were higher than control group （ P 〈 0.05 ）. Conclusion Video - assisted thoracoscopic thymectomy has positive clinical value for it can reduce operation wound, promote the recovery and relieve stress.