電視胸腔鏡下縱隔腫瘤切除術(shù)治療縱隔腫瘤的臨床效果觀察

照日格吐　周凌云　孫志剛

[摘要] 目的 探討電視胸腔鏡下縱隔腫瘤切除術(shù)治療縱隔腫瘤的臨床效果觀察。 方法 將2016年10月～2017年10月在我院胸外科治療的80例縱隔腫瘤患者隨機分為兩組，對照組采用開胸縱隔腫瘤切除術(shù)治療，觀察組采用電視胸腔鏡下縱隔腫瘤切除術(shù)治療，比較兩組患者的各項手術(shù)指標(biāo)、術(shù)后并發(fā)癥發(fā)生率、術(shù)后各項指標(biāo)情況。結(jié)果 觀察組術(shù)中出血量、術(shù)后下床活動時間、引流管留置時間、住院時間與對照組相比明顯減少（P<0.05），而兩組在手術(shù)時間方面無明顯差異（P>0.05）；觀察組術(shù)后肺部感染、胸腔粘連、肺不張、心律失常等并發(fā)癥發(fā)生率明顯低于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）；觀察組術(shù)后3 d VAS疼痛評分、皮質(zhì)醇（cortisol，COR）、促腎上腺皮質(zhì)激素（adrenocorticotropic hormone，ACTH）與對照組相比明顯降低，差異有統(tǒng)計學(xué)意義（P<0.05）。 結(jié)論 電視胸腔鏡下縱隔腫瘤切除術(shù)治療縱隔腫瘤的臨床效果顯著，術(shù)后恢復(fù)快，并發(fā)癥發(fā)生率低，術(shù)后疼痛輕，安全性高，具有積極的臨床意義。

[關(guān)鍵詞] 縱隔腫瘤；電視胸腔鏡；縱隔腫瘤切除術(shù)

[中圖分類號] R734.5 [文獻標(biāo)識碼] B [文章編號] 1673-9701（2018）19-0047-04

Observation on clinical effect of video-assisted thoracoscopicmediastinal tumor resection for the treatment of mediastinal tumor

Zhaorigetu ZHOU Lingyun SUN Zhigang

Department of Thoracic Surgery， Inner Mongolia Autonomous Region People's Hospital， Hohhot 010000， China

[Abstract] Objective To investigate the clinical effect of video-assisted thoracoscopicmediastinal tumor resection for the treatment of mediastinal tumors. Methods 80 patients with mediastinal tumor treated in the Department of Thoracic Surgery of our hospital from October 2016 to October 2017 were randomly divided into two groups. The control group was treated with resection of open mediastinal tumor and the observation group was treated with video-assisted thoracoscopicmediastinal tumor resection. The surgical indexes， the incidence of postoperative complications and postoperative index conditions between the two groups were compared. Results The intraoperative blood loss， postoperative ambulation time， drainage tube indwelling time and length of hospital stay in the observation group were significantly lower than those in the control group（P<0.05）. While there was no significant difference in the operation time between the two groups（P>0.05）. The incidence of complications such as postoperative pulmonary infection， pleural adhesions， atelectasis， and arrhythmia was significantly lower in the observation group than that in the control group， and the difference was significant（P<0.05）. The VAS pain score， COR（cortisol） and ACTH（adrenocorticotropic hormone） in the observation group on the third day after surgery were significantly lower than those of the control group， and the difference was statistically significant（P<0.05）. Conclusion Video-assisted thoracoscopicmediastinal tumor resection for mediastinal tumors has significant clinical effects， rapid postoperative recovery， low complication rate， mild postoperative pain and high safety， and has positive clinical significance.

[Key words] Mediastinal neoplasms； Video-assisted thoracoscopy； Mediastinal tumor resection

縱隔腫瘤多為良性腫瘤，早期無明顯癥狀，待瘤體增大可出現(xiàn)周圍組織壓迫病理反應(yīng)，發(fā)生疼痛、胸悶、呼吸困難等癥狀。除了惡性腫瘤，大部分縱隔腫瘤均能通過手術(shù)切除獲得治愈。常規(guī)開胸手術(shù)創(chuàng)傷大，并發(fā)癥多，術(shù)后恢復(fù)慢，已逐漸被微創(chuàng)手術(shù)所取代。電視胸腔鏡下縱隔腫瘤切除術(shù)是新型的微創(chuàng)術(shù)式，具有切口小、創(chuàng)傷小、術(shù)后恢復(fù)快等優(yōu)勢，受到了臨床的廣泛歡迎，但其對于巨大腫瘤的切除有一定困難[1]。本研究進一步分析電視胸腔鏡下縱隔腫瘤切除術(shù)治療縱隔腫瘤的臨床效果，現(xiàn)報道如下。

1 資料與方法

1.1 一般資料

將2016年10月～2017年10月在我院胸外科治療的80例縱隔腫瘤患者隨機分為兩組。觀察組40例，男21例，女19例，年齡24～68歲，平均（46.7±10.4）歲；……