微创手术治疗老年胸腺瘤的临床分析

Clinical Analysis of Minimally Invasive Surgery for the Patients with Thymoma in the Elderly

目的对胸腔镜与传统手术治疗老年胸腺瘤的临床情况和安全性进行比较分析,以体现胸腔镜治疗优越性。方法选取经CT或PET-CT确诊为胸腺瘤的患者92例,随机分为胸腔镜治疗组和传统手术治疗组各46例。术后记录两组患者的临床症状并进行随访。记录两组患者术中出血量、手术时间、术后止痛药使用情况,心肺功能恢复情况、住院时间和术后并发症,以及肿瘤复发和患者死亡情况。结果胸腔镜组患者术中出血量、手术时间、切口大小、止痛药使用情况、引流管留置时间和引流量,以及住院时间均较传统手术组少,明显优于传统手术组,差异具有统计学意义(P<0.05)。胸腔镜组患者术后并发症1例,不良反应1例;传统手术组患者术后并发症发生9例,不良反应7例,两组比较差异有统计学意义(P<0.05)。两组患者术后复发各1例,胸腔镜组6年内死亡1例,传统手术组死亡2例。肿瘤复发率和病死率两组差异均无统计学意义(P<0.05)。结论胸腔镜治疗老年胸腺瘤患者临床恢复情况好,术后并发症少,可推广成为老年胸腺瘤手术治疗的首选方法。

Objective To compare the thoracoscopy and traditional surgery for the patients with thymoma in the elderly. Methods 92 elderly patients with thymoma were divided to thoraeoseopy group and traditional surgery group（ n =46 each）. The clinical symptoms, the dose and duration of drainage, the operation time, wound size, blood loss, analgesic use and adverse reaction were observed. All patients were followed up for the rate of neoplasm and death for 6 years. Results The dose and duration of drainage, the operation time, wound size, blood loss and analgesic use in the thoraeoscopy group was lower than those of the other group （ P 〈 0.05 ）. The complications and adverse reactions in the two groups were 1,1 cases and 9,7 cases （ P 〈 0.05 ）. There were one each neoplasm in the two groups and one and two cases death in the thoraeoscopy group and traditional surgery group re-spectively（ P 〉 0.05 ）. Conclusion Thoracoseopy surgery was safe and can reduce the complications and adverse reactions in the elderly. It was suitable to generalized to be the first choice.