胸腔镜手术治疗纵隔肿瘤的疗效观察

Clinical Observation of Thoracoscopic Operation for Mediastinal Tumors

目的探讨胸腔镜手术治疗纵隔肿瘤的临床疗效。方法将94例纵隔肿瘤患者随机分为对照组和观察组,各47例。对照组患者行传统开胸手术。观察组患者行胸腔镜手术。结果观察组患者的手术时间(132.46±18.71)min、术中出血量(43.59±10.36)ml、切口长度(3.75±1.14)cm、术后引流量(367.35±108.54)ml、引流时间(3.24±1.06)d、术后住院时间(7.15±2.38)d,与对照组患者的手术时间(186.37±30.69)min、术中出血量(128.71±20.40)ml、切口长度(18.46±2.81)cm、术后引流量(653.41±150.73)ml、引流时间(5.82±1.30)d、术后住院时间(11.34±3.62)d相比,差异均具有统计学意义(P<0.01)。观察组患者的总有效率为93.62%,高于对照组患者的总有效率68.09%,差异具有统计学意义(P<0.01)。观察组患者并发症总发生率为12.77%,少于对照组患者并发症发生率59.57%,差异具有统计学意义(P<0.01)。结论胸腔镜手术治疗纵隔肿瘤疗效显著,且创伤小、恢复快、安全可靠,适用于大多数纵隔良性肿瘤,但切忌不可盲目追求"微创治疗",应严格把握手术的适应证和禁忌证。

Objective To observe the clinical efficacy of thoracoscopic operation for mediastinum tumors. Methods 94 cases of mediastinal tumors were randomly divided into the control group and the observation group,47 cases in each. The control group underwent conventional open chest operation,and the observation group underwent thoracoscopic surgery. Results In the observation group,operation time was( 132. 46 ± 18. 71) min,amount of bleeding during operation was( 43. 59 ± 10. 36) ml,length of incision was( 3. 75 ± 1. 14) cm,postoperative drainage was( 367. 35 ± 108. 54) ml,drainage time was( 3. 24 ± 1. 06) d,postoperative hospitalization time was( 7. 15 ± 2. 38) d; in the control group,operation time was( 186. 37 ± 30. 69) min,amount of bleeding during operation was( 128. 71 ± 20. 40) ml,length of incision was( 18. 46 ± 2. 81) cm,postoperative drainage was( 653. 41 ±150. 73) ml,drainage time was( 5. 82 ± 1. 30) d,postoperative hospitalization time was( 11. 34 ± 3. 62) d,there were statistically significant differences between the 2 groups( P < 0. 01). The total effective rate in the observation group was 93. 62%,which was higher than that of the control group 68. 09%,there had significant difference( P < 0. 01). Total complications rate in the observation group was 12. 77%,which was less than that of the control group 59. 57%,there had significant difference( P < 0. 01). Conclusion Thoracoscopic surgical treatment for mediastinal tumor is effective with small trauma and quick recovery,it is safe and reliable,and suitable for most benign tumor of mediastinum. We should avoid the blind pursuit of'minimally invasive treatment',and consider indications and contraindications of surgery.