胸腔镜治疗原发性纵隔肿瘤的疗效及安全性

Efficacy and Safety of Thoracoscopy in the Treatment of Primary Mediastinal Tumor

目的观察胸腔镜手术治疗原发性纵隔肿瘤的临床疗效,并对其安全性进行评价。方法选取2010年1月至2014年7月我院收治的72例原发性纵隔肿瘤患者为研究对象,将其随机分为两组各36例。观察组采取胸腔镜手术切除肿瘤,对照组采用传统经胸骨正中切开术。比较两组的手术时间、术中出血量、手术疗效、术后恢复情况以及并发症发生情况。结果观察组的手术时间与术中出血量分别为(115.35±13.69)min、(65.32±4.05)m L,均明显少于对照组的(136.52±16.72)min、(123.41±9.36)m L,差异具有统计学意义(P<0.05)。观察组术后拔除气管插管时间、止痛时间及住院时间均明显短于对照组,差异具有统计学意义(P<0.05)。两组有效率均为100.0%,组间未见显著性差异(P>0.05)。观察组并发症发生率为5.6%,显著低于对照组的27.8%,差异具有统计学意义(P<0.05)。结论胸腔镜手术治疗原发性纵隔肿瘤,具有手术创伤小、术后恢复快、并发症发生率低等特点,效果可靠且安全性高,可在临床推广试用。

Objective To observe the curative effect of thoracoscopic operation in the treatment of primary mediastinal tumor, and to evaluate its safety. Methods 72 cases of patients with primary mediastinal tumor admitted to our hospital from January 2010 to July 2014 were selected and randomly divided into observation group and control group, with 36 cases in each group. The observation group was given thoracoscopic operation for resecting tumor, the control group was given traditional median sternotomy. The operation time, bleeding volume, operation effects, postoperative recovery conditions and complications of two groups were compared. Results The operation time and bleeding volume of observation group were（115.35 ± 13.69） min and（65.32 ± 4.05） m L respectively, significantly less than（136.52 ±16.72） min and（123.41 ± 9.36） m L of control group, with statistically significant difference（P〈0.05）. The extubation time, analgesic time and hospitalization time of observation group were significantly shorter than those of control group, with statistical difference（P〈0.05）. Both the effective rate of two group were 100.0%, the difference was not statistical（P〉0.05）. The complications rate of observation group was5.6%, lower than 27.8% of control group, with statistical difference（P〈0.05）. Conclusions Thoracoscopic operation has small operation wound, rapid postoperative recovery and low complication rate in the treatment of primary mediastinal tumor, and has reliable effect and high safety, which can be popularized in clinic.