平卧分腿位下经剑突入路胸腔镜胸腺切除术的效果观察

Effect observation of video-assisted thoracoscopic thymectomy via subxiphoid approach under the supine and splitting position

目的分析经剑突入路实施胸腔镜胸腺切除术时采用平卧分腿位的临床效果。方法70例实施胸腔镜胸腺切除术治疗的患者,采取随机排列表法分成实验组与常规组,各35例。常规组患者选用侧卧位下经肋间隙入路实施手术,实验组患者选用平卧分腿位下经剑突入路实施手术。比较两组体位摆放时间、皮肤受压情况、视觉模拟评分法(VAS)评分以及并发症发生情况。结果实验组体位摆放时间(4.39±0.50)min短于常规组的(9.01±1.03)min,皮肤压红率5.71%、VAS评分(3.15±0.80)分均低于常规组的37.14%、(5.76±0.92)分,差异均具有统计学意义(P<0.05)。实验组并发症发生率为8.57%,低于常规组的31.43%,差异具有统计学意义(P<0.05)。结论平卧分腿位下经剑突入路行胸腔镜胸腺切除术,不仅可缩短患者体位摆放时间,缓解患者皮肤受压情况,还可提高手术治疗安全性,降低患者术后疼痛感,值得临床大力推广。

Objective To analyze the clinical effect of video-assisted thoracoscopic thymectomy via subxiphoid approach under the supine and splitting position.Methods A total of 70 patients undergoing videoassisted thoracoscopic thymectomy were divided into experimental group and conventional group by random permutation table method,with 35 cases in each group.The conventional group took the intercostal approach under the side-lying position,and the experimental group took the subxiphoid approach under the supine and splitting position.The posture time,skin pressure conditions,visual analogue scale(VAS)scores and occurrence of complications was compared between the two groups.Results The position time(4.39±0.50)min in the experimental group was shorter than(9.01±1.03)min in the conventional group,and skin flushing rate 5.71%and VAS score(3.15±0.80)points was lower than 37.14%and(5.76±0.92)points in the conventional group.Their difference was statistically significant(P<0.05).The incidence of complications was 8.57%in the experimental group,which was lower than 31.43%in the conventional group,and the difference was statistically significant(P<0.05).Conclusion Video-assisted thoracoscopic thymectomy via subxiphoid approach under the supine and splitting position can not only shorter position time,relieve skin flushing,but also can improve safety of surgical treatment and reduce the postoperative pain of patients.It is worthy of clinical promotion.