微创胸腔镜手术治疗纵膈肿瘤临床效果及对患者血浆中皮质醇、促肾上腺皮质激素浓度的影响研究

Efficacy of minimally invasive thoracoscopic surgery in treatment of mediastinal tumor and its influence on the concentration of cortisol and adrenocorticotropic hormone in patients’plasma

目的:分析纵膈肿瘤患者采取微创腹腔镜手术治疗对血浆促肾上腺皮质激素(ACTH)、皮质醇(COR)影响。方法:选择80例纵膈肿瘤患者以随机数字表法分组,对照组(40例)采纳传统开胸手术治疗,试验组(40例)采取微创胸腔镜手术治疗,对比两组手术指标、视觉模拟评分(VAS评分)、血浆ACTH、COR水平、并发症发生情况。结果:试验组手术时间、留置引流管时间、下床活动时间及住院时间均显著比对照组短,试验组术中出血量、术后3 d VAS评分、血浆COR、ACTH水平均显著比对照组低,试验组并发症发生率(2.50%)显著比对照组(22.50%)低,差异均具有统计学意义(P<0.05)。结论:微创胸腔镜手术可有效抑制纵膈肿瘤患者血浆COR、ACTH高表达,缩短治疗时间,减轻术后疼痛感,降低并发症发生率。

Objective:To analyze the efficacy of minimally invasive thoracoscopic surgery in treatment of mediastinal tumor and its influence on the concentration of cortisol(COR)and adrenocorticotropic hormone(ACTH)in patients’plasma.Methods:Eighty patients with mediastinal tumor were grouped by random number table method.The control group(40 patients)was treated with traditional thoracotomy,and the experimental group(40 patients)was treated with minimally invasive thoracoscopic surgery.The operation indexes,visual analogue score(VAS score),plasma ACTH,COR level and complications were compared between the two groups.Results:The operation time,indwelling drainage tube time,ambulation time and hospitalization time in the experimental group were significantly shorter than those in the control group;the intraoperative blood loss,VAS score 3 days after operration,plasma COR and ACTH levels in the experimental group were significantly lower than those in the control group;the incidence of complications in the experimental group(2.50%)was significantly lower than that in the reference group(22.50%)(P<0.05).Conclusion:Minimally invasive thoracoscopic surgery can effectively inhibit the high levels of COR and ACTH in the plasma of patients with mediastinal tumors,shorten the treatment time,reduce postoperative pain,and reduce the incidence of complications.