胸腔镜手术治疗纵隔肿瘤32例临床疗效观察

目的 与传统开胸手术比较, 探讨胸腔镜手术治疗纵隔肿瘤的临床效果及推广应用价值.方法 应用胸腔镜手术治疗2012年6月至2016年6月的32例纵隔肿瘤患者, 同时回顾性分析2003年1月至2012年6月接受传统开胸手术50例纵隔肿瘤患者的临床资料, 对比术中出血量、术后引流量、引流时间、镇痛时间、住院时间以及术后并发症发生率.结果 胸腔镜组VS开胸组:胸腔镜组32例均无中转开胸, 全组术中术后无死亡, 无二次开胸止血.全组术后出现切口感染6例, 肺不张8例;肺部感染8例, 未出现其他严重并发症.腔镜组术后切口感染、肺不张、肺部感染发生率较开胸组低 (P<0.05) ;术中出血 (188.7±28.77 vs 266.4±54.55) m L、术后引流 (212.3±28.48 vs 352.44±9.67) m L、引流时间 (2.65±0.71 vs 3.64±0.92) d、镇痛时间 (1.35±0.49 vs 2.38±0.49) d、住院时间 (8.74±0.89 vs 12.16±1.11) d, 2组比较有统计学意义 (P<0.05) .结论 胸腔镜手术治疗纵隔肿瘤较开胸手术具有明显优势, 具有临床推广价值.

Clinical Efficacy of Video-assisted Thoracic Surgery in Treatment of 32 Cases of Mediastinal Tumors

Objective To explore the clinical effect and application value of video-assisted thoracic surgery (VATS) for mediastinal tumor by comparing with traditional thoracotomy.Methods Thirty-two patients with mediastinal tumor were treated by VATS from June, 2012 to June, 2016 and the clinical data of 50 patients with mediastinal tumor undergoing thoracotomy from January 2003 to June 2012 were retrospectively analyzed.Results VATS group vs Thoracotomy group:There were no conversion thoracotomy, postoperative death, no thoracotomy for hemostasis in VATS group.There were 6 cases of incision infection, 8 cases of pulmonary infection, 8 cases of pulmonary infection, and no other serious complications in two groups.The incidence of incision infection, pulmonary atelectasis and pulmonary infection rate in VATS group was lower than thoracotomy group (P<0.05) .There were differences in the intraoperation bleeding volume (188.7±28.77 vs 266.4±54.55) m L, postoperative drainage (212.3±28.48 vs 352.44±9.67) m L, drainage time (2.65±0.71 vs 3.64±0.92) d, analgesia time (1.35±0.49 vs 2.38±0.49) d, hospitalization time (8.74±0.89 vs 12.16±1.11) d between two groups, P<0.05.Conclusion VATS in the treatment of mediastinal tumor has obvious advantages compared with traditional thoracotomy surgery, so it has good clinical efficacy and the the value of promotion.