经腋下中断肋骨开胸术的临床研究

Clinical study of transaxillary minithoracotomy with transeting rib

目的对比研究经腋下中断肋骨开胸术与传统后外侧切口开胸术的临床效果。方法连续50例肺部肿块患者随机分为两组:A组使用经腋下中断肋骨切口开胸术,B组采用传统方法,记录切口长度、开胸时间、关胸时间、胸内操作时间、术前及术后1周呼吸功能以及肩关节活动度、术后疼痛的评估使用术后72h内强痛定使用量来完成。结果胸内操作时间、呼吸功能两组无差异(P>0.05),但开胸时间、关胸时间、术后肩关节活动度以及疼痛的减轻程度A组优于B组(P<0.05),切口长度A组短于B组(P<0.05)。结论经腋下中断肋骨开胸术优于传统后外切口,值得推广应用。

[Objective] To compare the clinical effect between the transaxillary minithoracotomy with transeting rib （TMTR） and the conventional posterolateral thoracotomy （SPT）. [Methods] 50 patients with the lung mass undergoing surgical treatment were randomly divided into two groups respectively, （A： TMTR group and B： SPT group）, and compared the surgical approach time, postoperative pain, pulmonary function, shoulder＇s range of motion, sizes of the incision between TMPR and SPT. [ Results] There are no differences in the time of intrathoracic operative process, and pulmonary function. There were significantly less time of opening and closing of thoracic incision and less postoperative pain and the sizes of incision in TMPR group, the shoulder function was preserved better in TMPR group than that of SPT group. [Conclusion] TMPR may be a sensible alternative to the standard posterolateral thoracotomy.