电视胸腔镜与开胸手术治疗重症肌无力的疗效及安全性分析

Analysis of the Efficacy and Safety of Video Assisted Thoracic Surgery and Thoracic Surgery in the Treatment of Myasthenia Gravis

目的:探讨电视胸腔镜与开胸手术治疗重症肌无力的疗效及安全性。方法:选取60例重症肌无力患者,按随机数字表法分为两组,观察组(32例)采用电视胸腔镜手术治疗,对照组(28例)采用开胸手术治疗,观察并记录两组围手术期指标,两组术前、术后3个月、6个月QMG评分及随访6个月期间并发症的发生情况。结果:围手术期间,两组手术时间相比差异无统计学意义(P>0.05),观察组术中出血量少于对照组,术中引流时间、住院时间及切口长度均短于对照组(P<0.05)。术前,两组QMG评分比较无统计学差异(P>0.05),术后3个月、6个月,两组QMG评分均较治疗前显著降低,且观察组QMG评分均低于对照组(P<0.05)。随访6个月期间,观察组并发症7例,对照组并发症17例,主要并发症为肺部感染,观察组并发症发生率显著低于对照组(P<0.05)。结论:采用电视胸腔镜手术治疗重症肌无力具有手术切口小、患者术后恢复快,手术安全性较高的优点。

Objective： To investigate the efficacy and safety of video assisted thoracic surgery and thoracic surgery in the treatment ofmyasthenia gravis. Methods： 60 patients with myasthenia gravis were selected and randomly divided into two groups. The observation group（32 cases） received video assisted thoracic surgery. The control group（28 cases） received thoracic surgery. The efficacy and safety of video assisted thoracic surgery and thoracic surgery in the treatment of myasthenia gravis was evaluated by perioperative indexes, QMG scores before operation, after 3 months, 6 months operation and complications during 6 months follow-up. Results： During the perioperative period, there was no statistical significance in the operation time between two groups（P〉0.05）. The bleeding volume of observation group was less than that of the control group （P〈0.05）. The drainage time, hospitalization and incision length of observation group were shorter than those of the control group （P〈0.05）. Before operation, there was no statistical significance in the QMG scores. At 3 months, 6 months atter operation, the QMG scores were decreased in both groups. The QMG score of observation group was lower than that of the control group （P〈0.05）. During 6 months＇ follow-up, complications were observed in 7 cases of the observation group and 17 cases of the control group, the major complication was pulmonary infection. The incidence of complications in the control group was higher than that of the observation group （P〈0.05）. Conclusion： Video assisted thoracic surgery had advantages of smaller surgical incision, faster recovery and higher safety in the treatment ofmyasthenia gravis.