剑突入路胸腔镜手术对前纵隔肿瘤患者应激指标及血清肿瘤标志物的影响

Effect Exploration of Thoracoscopic Surgery via Xiphoid Process Approach in Improving Stress Response and Serum Tumor Markers of Patients with Anterior Mediastinal Tumors

目的探讨剑突入路胸腔镜手术对前纵隔肿瘤患者应激指标及血清肿瘤标志的影响。方法将2020年1月—2023年6月在本院胸外科治疗的72例前纵隔肿瘤患者随机分为两组,对照组使用侧胸入路胸腔镜手术,观察组使用剑突入路胸腔镜手术,对比两组的各项手术指标、炎症及应激反应指标、肿瘤标志物。结果两组手术时间相当(P>0.05),观察组术中出血量、胸腔引流量均少于对照组,拔管时间、镇痛药物使用时间、住院时间均短于对照组(P<0.05);观察组术后3d的C反应蛋白(CRP)、白细胞计数(WBC)、前列腺素E2(PGE2)、P物质(SP)、人神经肽Y(NPY)数值均低于对照组(P<0.05);观察组术后3d的癌胚抗原(CEA)、神经特异性烯醇(NSE)与对照组相当(P>0.05)。结论采用剑突入路胸腔镜手术治疗前纵隔肿瘤,效果显著,能有效切除肿瘤,降低肿瘤标志物水平,减轻炎症及应激反应程度,术后患者疼痛轻,恢复快。

Objective To explore effect of thoracoscopic surgery via xiphoid process approach in improving stress response and serum tumor markers of patients with anterior mediastinal tumors.Methods The paper chose 72 patients with anterior mediastinal tumors in thoracic surgery department of our hospital from January 2020 to June 2023,and divided them into two groups randomly.Control group was treated with thoracoscopy via lateral thoracic approach,while observation group with thoracoscopy via xiphoid process approach.Surgical indicators,inflammation and stress response indicators,and tumor markers between two groups were compared.Results Two groups had similar surgical time(P>0.05),observation group had less intraoperative bleeding,chest drainage volume,extubation time,analgesic drug use time,and hospital stay than control group(P<0.05).Levels of CRP,WBC,PGE2,SP,and NPY in observation group were lower than control group on postoperative day 3(P<0.05).CEA and NSE levels in observation group were comparable to control group on postoperative day 3(P>0.05).Conclusion Thoracoscopic surgery via xiphoid process approach can achieve good curative effect for anterior mediastinal tumors,remove tumor effectively,reduce tumor marker levels,alleviate inflammation and stress response,with less postopera tive pain and faster recovery.