胸腔镜下微创手术治疗纵隔肿瘤患者的临床疗效及并发症发生率影响评价

Clinical Curative Effect of Minimally Invasive Thoracoscopic Surgery in Treatment of Patients with Mediastinal Mass and Evaluation of Effect on the Incidence Rate of Complications

目的探讨胸腔镜下微创手术治疗纵隔肿瘤患者的临床疗效及并发症发生率影响。方法研究时段为2016年2月—2018年6月,研究对象为该院收治的纵膈肿瘤患者,共方便选择76例,根据患者入院时间先后进行编号,利用计算机软件、遵照"随机"原则进行分组,具体分为对照组和观察组,每组38例,对照组实施开胸纵膈肿瘤切除术治疗,观察组实施胸腔镜下微创手术治疗,观察对比两组患者治疗情况和并发症发生情况。结果与对照组相比,观察组术中出血量(54.47±6.75)mL较少,引流管留置时间(1.05±0.87)d、住院时间(3.01±0.37)d较短(t=16.644、8.028、16.743,P<0.05);术前3 d和术后3 d,观察组皮质醇(COR)、促肾上腺皮质激素(ACTH)与对照组相比不存在统计学差异,(P>0.05),术后两组患者上述指标均升高,但观察组COR (91.44±9.86)ng/mL、ACTH (4.01±0.64)ng/mL较对照组低(P<0.05);观察组并发症发生率为5.26%,与对照组21.04%相比较低(χ~2=4.156,P<0.05)。结论在纵膈肿瘤患者治疗中,胸腔镜下微创手术治疗创伤较小,患者术后恢复较快,并发症发生率低,推荐探索性推广。

Objective To study the curative effect of minimally invasive thoracoscopic surgery in treatment of patients with mediastinal mass and evaluation of effect on the incidence rate of complications.Methods 76 cases of patients with mediastinal mass admitted and treated in our hospital from February 2016 to June 2018 were convenient selected and randomly divided into two groups with 38 cases in each,the control group were treated with excision of thoracotomy mediastinum tumor,while the observation group were treated with minimally invasive thoracoscopic surgery,and the treatment effect and occurrence of complications were observed.Results The intraoperative bleeding amount,drainage tube indwelling time and length of stay in the observation group were shorter than those in the control group,which were respectively(54.47±6.75)mL,(1.05±0.87)d,(3.01±0.37)d(t=16.644,8.028,16.743,P﹤0.05),and the differences in the COR and ACTH between the two groups were not statistically significant in 3 d before and after surgery(P﹥0.05),and the above indexes of the two groups after surgery increased,but the COR and ACTH in the observation group were respectively(91.44±9.86)ng/mL and(4.01±0.64)ng/mL,which were lower than those in the control group(P﹤0.05),and the incidence rate of complications in the observation group was lower than that in the control group(5.26%vs 21.04%)(χ^2=4.156,P﹤0.05).Conclusion The wound of minimally invasive thoracoscopic surgery in treatment of patients with mediastinal mass is small,with rapid postoperative recovery and low incidence rate of complications,and it is recommended to be promoted.