经剑突下入路与经侧胸入路胸腔镜手术治疗胸腺瘤合并重症肌无力的对照研究

A Comparative Study of the Subxiphoid Approach and the Lateral Thoracic Approach for the Treatment of Thymoma with Myasthenia Gravis

目的:探讨经剑突下入路全胸腔镜手术治疗胸腺瘤合并重症肌无力的临床疗效和预后。方法:选取2019年1月~2021年2月于本院住院治疗的胸腺瘤合并重症肌无力的患者40例,随机分为观察组和对照组,每组20例。观察组采取经剑突下入路,对照组采取经侧胸入路。结果:所有患者无围手术期死亡,无中转开胸,术后未发生肌无力危象。两组患者临床指标(术中出血量、术后带管时间、术后引流量、术后住院时间)对比无差异,两组患者术后并发症发生率对比无统计学意义(P>0.05)。观察组手术时间明显短于对照组,观察组术后疼痛情况亦优于对照组(P<0.05)。结论:经剑突下全胸腔镜手术治疗胸腺瘤伴重症肌无力安全,可靠,并且具有手术时间短、术后疼痛症状轻的优点,临床疗效佳。

Objective:To investigate the clinical efficacy and prognosis of total thoracoscopic surgery through the subxiphoid approach in the treatment of thymoma with myasthenia gravis.Methods:Forty patients with thymoma and myasthenia gravis who were hospitalized in our hospital from January 2019 to February 2021 were selected as the research objects,and they were randomly divided into a test group and a control group,each group 20 cases.The experimental group adopted the subxiphoid approach,and the control group adopted the lateral thoracic approach.Results:There were no perioperative deaths in all patients,no conversion to thoracotomy,and no myasthenia crisis after surgery.There was no difference in clinical indicators(intraoperative blood loss,postoperative catheterization time,postoperative drainage,postoperative hospital stay)between the two groups of patients,and there was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).The operation time of the experimental group was significantly shorter than that of the control group,and the postoperative pain of the experimental group was also better than that of the control group(P<0.05).Conclusion:Total thoracoscopic surgery under the xiphoid process for the treatment of thymoma with myasthenia gravis is safe,reliable,and has the advantages of short operation time and mild postoperative pain.The clinical effect is good.