胸腔镜剑突下切口入路治疗老年纵隔肿瘤的临床疗效观察

Observation on clinical efficacy of thoracoscopic subxiphoid incision approach in the treatment of mediastinal tumors in the elderly

目的 探讨胸腔镜剑突下切口入路治疗老年纵隔肿瘤的临床疗效。方法 52例老年纵隔肿瘤患者,通过计算机随机数字表法分为观察组与对照组,每组26例。对照组行胸腔镜单侧肋间切口入路治疗,观察组行胸腔镜剑突下切口入路治疗。对比两组术中出血量、手术时间、术后24 h视觉模拟评分法(VAS)评分、并发症发生情况。结果 观察组患者的术中出血量(132.58±32.16)ml少于对照组的(157.81±35.25)ml、手术时间(46.58±16.32)min短于对照组的(61.42±20.59)min、术后24 h VAS评分(1.93±0.56)分低于对照组的(2.49±0.72)分,差异具有统计学意义(P<0.05)。观察组并发症发生率3.85%低于对照组的26.92%,差异具有统计学意义(P<0.05)。结论 胸腔镜剑突下切口入路治疗老年纵隔肿瘤可减少术中出血量及手术时间,促进预后恢复,且并发症发生率低,有临床推广应用价值。

Objective To discuss the clinical efficacy of thoracoscopic subxiphoid incision approach in the treatment of mediastinal tumors in the elderly.Methods A total of 52 elderly patients with mediastinal tumor were divided into an observation group and a control group by computer random numerical table,with 26 cases in each group.The control group was treated by thoracoscopic unilateral intercostal incision approach,and the observation group was treated by thoracoscopic subxiphoid incision approach.The intraoperative blood loss,operative time,visual analogue scale(VAS)score at 24 h after surgery and the incidence of complications were compared between the two groups.Results The intraoperative blood loss of(132.58±32.16)ml in the observation group was less than that of(157.81±35.25)ml in the control group,the operative time of(46.58±16.32)min was shorter than that of(61.42±20.59)min in the control group,and the VAS score of(1.93±0.56)points at 24 h after surgery was lower than that of(2.49±0.72)points in the control group.The differences were statistically significant(P<0.05).The complication rate of 3.85%in the observation group was lower than that of 26.92%in the control group,and the difference was statistically significant(P<0.05).Conclusion Thoracoscopic subxiphoid incision approach for the treatment of mediastinal tumors in the elderly can reduce the intraoperative blood loss and the operative time,promote the recovery of prognosis,and has a low incidence of complications.It has the value of clinical application.