摘要
目的探讨高血压对达芬奇机器人经剑突纵隔肿瘤切除术后并发症的影响。方法选择2019年1月至2022年3月兰州大学第一医院胸外科收治的行达芬奇机器人经剑突纵隔肿瘤切除术的77例患者为研究对象。根据术前是否有高血压将患者分为高血压组(n=21)与无高血压组(n=56),并依据高血压分级标准将高血压组患者分为高血压1级组(n=7)、高血压2级组(n=8)和高血压3级组(n=6)。比较高血压组与无高血压组及不同高血压分级组患者的年龄、性别、身高、体质量、体质量指数(BMI)、吸烟史、饮酒史、肿瘤最大径、病理类型等一般临床资料,以及术前麻醉时间、手术时间、术中出血量、术后视觉模拟疼痛评分(VAS)、术后使用镇痛泵时间、术后下床活动时间、胸腔引流量、胸管拔除时间、术后住院时间、住院费用等手术相关指标和术后并发症发生率。结果无高血压组与高血压组患者的年龄、性别、身高、BMI、吸烟史、饮酒史、肿瘤最大径、病理类型、术前麻醉时间、手术时间、术中出血量、术后VAS评分、术后镇痛泵使用时间比较差异无统计学意义(P>0.05);高血压组患者的术后下床活动时间显著晚于无高血压组,术后住院时间、胸管拔除时间显著长于无高血压组,胸腔引流量、住院费用显著多于无高血压组(P<0.05)。高血压组患者术后心包积液、心律失常、肺部感染、胸腔积液发生率显著高于无高血压组(P<0.05);2组患者术后重症肌无力、声音嘶哑、切口感染发生率比较差异无统计学意义(P>0.05)。高血压1级组、高血压2级组和高血压3级组患者的一般临床资料、手术资料和术后并发症比较差异均无统计学意义(P>0.05)。结论高血压可增加行达芬奇机器人经剑突纵隔肿瘤切除术患者术后心包积液、心律失常、肺部感染及胸腔积液的发生率,减缓患者术后康复,增加患者经济、疼痛负担,延长住院时间;高血压的严重程度对术后相关并发症的发生、术后康复、患者的经济及疼痛负担和住院时间并无显著影响。
Objective To investigate the effect of hypertension on the complications after transxiphoid mediastinal tumor resection by Da Vinci robot.Methods A total of 77 patients who underwent transxiphoid mediastinal tumors resection by Da Vinci robotic in the Department of Thoracic Surgery,Lanzhou University First Hospital from January 2019 to March 2022 were selected as the study subjects.The patients were divided into hypertension group(n=21)and non-hypertension group(n=56)based on whether they had hypertension before surgery,and patients in the hypertension group were divided into hypertension grade 1 group(n=7),hypertension grade 2 group(n=8),and hypertension grade 3 group(n=6)according to the hypertension grading criteria.The general clinical data such as age,gender,height,body mass,body mass index(BMI),smoking history,alcohol consumption history,tumor maximum diameter,pathological type,and surgical related indicators including the preoperative anesthesia time,surgical time,intraoperative bleeding volume,postoperative visual analog pain score(VAS),postoperative use of analgesic pump,time to get out of bed,thoracic drainage flow,thoracic tube extraction time,postoperative hospitalization time,hospitalization costs,and the rate of postoperative complication of patients between the hypertension group and non-hypertension group and among the different grade of hypertension groups were compared.Results There were no significant differences in age,gender,height,BMI,smoking history,alcohol consumption history,tumor maximum diameter and pathological type,preoperative anesthesia time,surgical time,intraoperative bleeding volume,postoperative VAS score and postoperative analgesia pump use time between the non-hypertensive group and the hypertension group(P>0.05);the time to get out of bed of the patients in the hypertension group was significantly later than that in the non-hypertension group,postoperative hospitalization time and thoracic tube extraction time were significantly longer than those in the non-hypertension group,and the thoracic drainage flow and hospitalization costs were more than those in the non-hypertension group(P<0.05).The incidences of postoperative pericardial effusion,arrhythmia,pulmonary infection and pleural effusion of patients in the hypertension group were significantly higher than those in the non-hypertension group(P<0.05);there was no significant difference in the incidence of postoperative myasthenia gravis,hoarseness and incision infection of patients between the two groups(P>0.05).There were no significant differences in general clinical data,surgical related indicators and postoperative complications of the patients among the hypertension grade 1 group,hypertension grade 2 group,and hypertension grade 3 group(P>0.05).Conclusion Hypertension can increase the incidence of postoperative pericardial effusion,arrhythmia,lung infection and pleural effusion complications in patients undergoing Da Vinci robotic transxiphoid mediastinal tumor resection,retard the postoperative recovery of patients,increase the patient′s economy and pain burden,and prolong the length of hospital stay;the severity of hypertension has no significant effect on the occurrence of postoperative related complications,postoperative rehabilitation,economy and pain burden,and postoperative hospitalization time.
作者
韩志伟
胡文滕
马敏杰
蔺瑞江
梁秋豪
袁博文
韩彪
HAN Zhiwei;HU Wenteng;MA Minjie;LIN Ruijiang;LIANG Qiuhao;YUAN Bowen;HAN Biao(The First Clinical Medical College,Lanzhou University,Lanzhou 730000,Gansu Province,China;Department of Thoracic Surgery,the First Hospital of Lanzhou University,Lanzhou 730000,Gansu Province,China;Major in R&D and Application of Key Technologies in Thoracic Surgery Gansu International Science and Technology Cooperation Base,Lanzhou 730000,Gansu Province,China;Gansu Provincial Medical Quality Control Center of Thoracic,Lanzhou 730000,Gansu Province,China)
出处
《新乡医学院学报》
CAS
2023年第5期437-442,447,共7页
Journal of Xinxiang Medical University
基金
甘肃省青年科技基金项目(编号:21JR1RA107)
甘肃省自然科学基金项目(编号:21JR1RA118)。
关键词
高血压
达芬奇机器人
经剑突纵隔肿瘤切除术
术后并发症
hypertension
Da Vinci robot
transxiphoid mediastinal tumor resection
postoperative complication
