摘要
目的研究快速康复外科(FTS)理念指导下的单孔电视辅助胸腔镜(SPVATS)纵隔肿瘤切除术在原发性纵隔肿瘤(PMT)的应用效果。方法选取我院2019年1月至2021年12月收治的60例PMT患者,按照随机数字表法将其分为对照组和干预组,每组30例。对照组给予常规处理+三孔胸腔镜纵隔肿瘤切除术,干预组给予FTS理念指导下的SPVATS纵隔肿瘤切除术。比较两组的治疗效果。结果干预组的手术时间、引流时间、首次下床活动时间、住院时间均短于对照组,术中出血量、术后引流量、住院费用均少于对照组(P<0.05)。术后5 d,干预组的C-反应蛋白、白细胞介素-6水平及白细胞计数、红细胞沉降率均低于对照组(P<0.05)。术后1 d,干预组的去甲肾上腺素、内皮素、皮质醇水平均低于对照组(P<0.05)。术后12、24、48、72 h,干预组的视觉模拟评分法(VAS)评分均低于对照组(P<0.05)。结论FTS理念指导下的SPVATS纵隔肿瘤切除术中不仅能改善PMT患者的手术指标,还能减轻术后的炎症反应、应激反应及疼痛程度。
Objective To study the application effect of single-port video assisted thoracoscopic surgery(SPVATS)mediastinal tumor resection under the guidance of the concept of fast track surgery(FTS)in primary mediastinal tumor(PMT).Methods Sixty patients with PMT admitted in our hospital from January 2019 to December 2021 were selected and divided into control group and intervention group according to the random number table method,with 30 cases in each group.The control group was given routine treatment+three-hole thoracoscopic mediastinal tumor resection,and the intervention group was given SPVATS mediastinal tumor resection under the guidance of the concept of FTS.The therapeutic effects of the two groups were compared.Results The operation time,drainage time,first ambulation time and hospitalization time of the intervention group were shorter than those of the control group,and the intraoperative blood loss,postoperative drainage volume and hospitalization cost were less than those of the control group(P<0.05).At 5 d after operation,the levels of C-reactive protein,interleukin-6,white blood cell count and erythrocyte sedimentation rate in the intervention group were lower than those in the control group(P<0.05).At 1 d after operation,the levels of norepinephrine,endothelin and cortisol in the intervention group were lower than those in the control group(P<0.05).At 12,24,48 and 72 h after operation,the score of Visual Analogue Scale(VAS)in the intervention group was lower than that in the control group(P<0.05).Conclusion The SPVATS mediastinal tumor resection under the guidance of the concept of FTS can not only improve the surgical indexes of PMT patients,but also reduce the postoperative inflammatory response,stress response and pain degree.
作者
张涛
李勃
明怀德
ZHANG Tao;LI Bo;MING Huaide(Xianyang Central Hospital,Xianyang 712000,China)
出处
《临床医学研究与实践》
2023年第13期26-29,共4页
Clinical Research and Practice
基金
咸阳市二0一九年重点研发计划(No.2019KO2-93)。
关键词
快速康复外科理念
单孔电视辅助胸腔镜手术
原发性纵隔肿瘤
the concept of fast track surgery
single-port video assisted thoracoscopic surgery
primary mediastinal tumor
