剑突下胸腔镜与前胸正中切口治疗前纵隔肿瘤合并重症肌无力的临床疗效对比

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

目的剑突下胸腔镜与前胸正中切口治疗前纵隔肿瘤合并重症肌无力的临床疗效对比。方法选取2020年6月到2022年6月住院治疗的胸腺瘤合并重症肌无力患者20例。根据手术方式不同分为剑突下胸腔镜手术组(A组,n=10)和前胸正中切口手术组(B组,n=10)。对两组患者术中临床指标,术后疼痛情况,手术后并发症以及重症肌无力症状改善情况进行评估。结果A组患者术中出血量以及镇痛次数均显著少于B组(P<0.05),术后引流时间、住院时间均显著短于B组(P<0.05)。术后两组重症肌无力症状改善对比无明显差异。结论剑突下胸腔镜手术治疗可显著缩短手术时间,促进患者术后快速康复,降低各类并发症发生率。

Objective To compare the clinical efficacy and prognosis of thoracic surgery through the subxiphoid ap⁃proach and the sternotomy approach in the treatment of thymoma with myasthenia gravis.Methods 20 patients with thymoma and myasthenia gravis who were hospitalized in our hospital from June 2020 to June 2022 were selected in the research objects,According to the different surgical methods,it is divided into the subsvex thora⁃coscopic surgery group(group A,n=10)and the anterior chest center incision surgery group(group B,n=10).The intraoperative clinical indicators,postoperative pain,postoperative complications,and improvement of myas⁃thenia gravis symptoms were evaluated in both groups.Results The intraoperative bleeding volume and the num⁃ber of analgesia in group A were significantly less than those in group B(P<0.05),and the postoperative drainage time and hospital stay were significantly shorter than those in group B(P<0.05).There was no significant differ⁃ence in the improvement of myasthenia gravis symptoms between the two groups after surgery(P>0.05).Con⁃clusion The surgery under the xiphoid process for the treatment of thymoma with myasthenia gravis can signifi⁃cantly shorten the operation time,promote the rapid recovery of patients after surgery,and reduce the incidence of various complications.