摘要
目的探讨tubeless经剑突下胸腔镜前纵隔肿瘤切除手术的安全性、可行性及优越性。方法回顾性分析2016年6月至2018年6月兰州大学第一医院胸外科前纵隔肿瘤32例患者的临床资料,17例行tubeless经剑突下胸腔镜前纵隔肿瘤切除手术,男8例、女9例,年龄(31.8±8.4)岁;15例行传统经剑突下胸腔镜前纵隔肿瘤切除手术,男8例、女7例,年龄(31.1±9.2)岁。对比手术时间、术中最低血氧饱和度(SaO_2)、术后清醒时间、术后疼痛视觉模拟评分、术后肺完全复张时间、术后住院时间、住院费用等。结果 Tubeless组术后清醒时间[(18.5±1.8)min vs.(28.9±4.2)min,P=0.000]、术后疼痛视觉模拟评分(1.6±0.6 vs. 3.5±7.4,P=0.000)、术后住院时间[(2.5±7.2)d vs.(4.3±1.1)d,P=0.000]、住院费用[(3.2±1.1)万元vs.(4.9±1.1)万元,P=0.000]均优于对照组。两组患者手术时间[(51.7±6.5)min vs.(55.1±8.5)min]、术中最低SaO_2(98.5%±0.9%vs. 98.1%±0.8%)、术后肺复张时间[(33.9±12.2)d vs.(38.4±15.2)d]差异均无统计学意义(P>0.05)。结论 Tubeless经剑突下胸腔镜前纵隔肿瘤切除手术安全可行,并具有显著的优越性。
Objective To discuss the safety, feasibility and advantages of tubeless trans-subxiphoid thoracoscopic surgery in anterior mediastinal tumor resection. Methods A total of 32 patients suffering anterior mediastinal tumor were enrolled, including 17 patients(8 males and 9 females) with average age of 31.8±8.4 years who had been performed tubeless trans-subxipohoid tharcoscopic surgery and 15 patients(8 males and 7 females) with average age of 31.1±9.2 years who had been performed traditional trans-subxipohoid tharcoscopic surgery. The differences of surgical duration, the lowest intraoperative arterial oxygen saturation(SaO2), postoperative awaking time, postoperative pain visual analogue score(VAS), postoperative pulmonary recruitment time, duration of postoperative hospital stay and hospitalization cost were analyzed. Results Postoperative awaking time(18.5±1.8 min vs. 28.9±4.2 min, P=0.000), postoperative VAS(1.6±0.6 vs. 3.5±7.4, P=0.000), duration of postoperative hospital stay(2.5±7.2 d vs. 4.3±1.1 d, P=0.000) and hospitalization cost(3.2±1.1 ten thousand RMB vs. 4.9±1.1 10 ten thousand RMB, P=0.000) in the tubeless group were better than those in the control group. There was no significant difference in surgical duration(51.7±6.5 min vs. 55.1±8.5 min), the lowest intraoperative SaO2(98.5%±0.9% vs. 98.1%±0.8%), postoperative pulmonary recruitment time(33.9±12.2 d vs. 38.4±15.2 d, P>0.05) between the two groups. Conclusion Tubeless trans-subxiphoid thoracoscopic surgery is safe, feasible and advanced in anterior mediastinal tumor resection.
作者
岳瀚逊
张瑜
马敏杰
魏宁
霍斌
蔺瑞江
韩彪
YUE Hanxun;ZHANG Yu;MA Minjie;WEI Ning;HUO Bin;LIN Ruijiang;HAN Biao(Department of Thoracic Surgeryy Lanzhou University First Hospital,Lanzhou,730000. P.R.China;Department of Anesthesiology,Lanzhou University First Hospital,Lanzhou,730000,P.R.China)
出处
《中国胸心血管外科临床杂志》
CAS
CSCD
2019年第4期353-357,共5页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
甘肃省自然科学基金(1606RJZA129)
甘肃省省青年科技基金(1606RJYA283)
关键词
自主呼吸麻醉
加速康复外科
胸腔镜
纵隔肿瘤
Spontaneous breathing anesthesia
enhanced recovery after surgery
thoracoscopy
mediastinal tumor
