剑突下胸腔镜手术在前纵隔肿瘤切除患者中的有效性和安全性分析

Effectiveness and Safety of Subxiphoid Thoracoscopy in Patients with Anterior Mediastinal Tumor Resection

目的观察剑突下单孔胸腔镜手术在前纵隔肿瘤切除患者中的有效性及安全性。方法选取2018年8月-2020年8月宁夏医科大学总医院诊治的48例前纵隔肿瘤患者为研究对象,采用随机数字表法分为对照组和观察组,各24例。对照组采用三孔胸腔镜手术,观察组采用剑突下单孔胸腔镜手术,比较两组临床手术指标、疼痛评分、生活质量评分、并发症发生率以及炎症因子水平[白细胞介素-6(IL-6)、降钙素(PCT)]。结果观察组手术切口、手术时间、术中出血量、引流置管时间均小于对照组(P<0.05);观察组术后12、24 h疼痛评分均低于对照组(P<0.05);观察组生活质量各维度评分均高于对照组(P<0.05);观察组并发症发生率为8.33%,低于对照组的20.83%(P<0.05);观察组IL-6、PCT水平均低于对照组(P<0.05)。结论前纵隔肿瘤患者采用剑突下单孔胸腔镜手术治疗效果确切,可降低并发症发生率,减轻疼痛,提高生活质量水平,降低炎症因子水平,进而促进患者的康复。

Objective To observe the efficacy and safety of subxiphoid single-port thoracoscopy in patients with anterior mediastinal tumor resection.Methods Forty-eight patients with anterior mediastinal tumors treated in General Hospital of Ningxia Medical University from August 2018 to August 2020 were selected as the study subjects.They were divided into control group and observation group by random number table method,with 24 cases in each group.The control group was treated with three-port thoracoscopy,and the observation group was treated with subxiphoid single-port thoracoscopy.The clinical operation indexes,pain scores,quality of life scores,incidence of complications and levels of inflammatory factors[interleukin-6(IL-6),calcitonin(PCT)]were compared between the two groups.Results The operative incision,operative time,intraoperative blood loss and drainage time in the observation group were all less than those in the control group(P<0.05).The pain scores at 12 and 24 h after operation in the observation group were lower than those in the control group(P<0.05).The scores of each dimension of quality of life in the observation group were higher than those in the control group(P<0.05).The incidence of complications in the observation group was 8.33%,which was lower than 20.83%in the control group(P<0.05).The levels of IL-6 and PCT in the observation group were lower than those in the control group(P<0.05).Conclusion Subxiphoid single-port thoracoscopy is effective in the treatment of anterior mediastinal tumors,which can reduce the incidence of complications,reduce the pain score,improve the quality of life,reduce the level of inflammatory factors and promote the recovery of patients.