| 摘要: |
| ［摘要］ 目的 比较改良经剑突下及肋弓下切口术式与充气式剑突下入路切除胸腺肿瘤的临床疗效。 方法 回顾性分析2021年6月至2024年2月保定市第二中心医院收治的80例胸腺肿瘤患者的临床资料，根据治疗方法不同将其分为对照组（行充气式剑突下入路切除，38例）和观察组（行改良经剑突下及肋弓下切口术式切除，42例）。比较两组手术相关指标、肺功能指标、炎症指标、术后视觉模拟量表（VAS）评分、止痛泵按压次数、临床疗效及术后不良反应发生情况。结果 观察组手术时间、术后置管时间、住院时间短于对照组，术中出血量、术后引流量少于对照组，差异有统计学意义（P<0.05）。观察组术后用力肺活量（FVC）、第1秒用力呼气容积（FEV1）水平均高于对照组，红细胞沉降率（ESR）、C反应蛋白（CRP）、白细胞介素-6（IL-6）水平均低于对照组，差异有统计学意义（P<0.05）。观察组术后4 h、24 h的VAS评分低于对照组，止痛泵按压次数少于对照组，差异有统计学意义（P<0.05）。观察组临床总有效率显著高于对照组（90.48% vs 73.68%； χ2=3.869，P=0.048），术后不良反应发生率显著低于对照组（7.14% vs 23.68%； χ2=4.281，P=0.038）。结论 与充气式剑突下入路切除胸腺肿瘤相比，改良经剑突下及肋弓下切口术式的术中出血量更少，患者康复更快，临床总有效率更高，不良反应发生率更低，值得临床推荐。 |
| 关键词: 改良经剑突下及肋弓下切口术式 胸腺肿瘤 充气式剑突下入路 临床疗效 不良反应 |
| DOI：10.3969/j.issn.1674-3806.2025.06.17 |
| 分类号: |
| 基金项目:保定市科技计划项目（编号：1951ZF031） |
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| A comparative study on the clinical efficacy of modified subxiphoid and subcostal incision procedure and inflatable subxiphoid approach for thymic tumor resection |
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MA Xingang, YUAN Xin, WANG Yanbing, CHEN Xiaofeng, YAN Yingguang, WANG Xingang
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Department of Thoracic and Cardiovascular Surgery, Baoding No.2 Central Hospital, Baoding 072750, China
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| Abstract: |
| ［Abstract］ Objective To compare the clinical efficacy of modified subxiphoid and subcostal incision procedure and inflatable subxiphoid approach for thymic tumor resection. Methods The clinical data of 80 patients with thymic tumors who were admitted to Baoding No.2 Central Hospital from June 2021 to February 2024 were retrospectively analyzed. According to different treatment methods, the patients were divided into control group(undergoing inflatable subxiphoid approach for thymic tumor resection, 38 cases) and observation group(undergoing modified subxiphoid and subcostal incision procedure for thymic tumor resection, 42 cases). The operation-related indicators, pulmonary function indicators, inflammatory indicators, postoperative Visual Analogue Scale(VAS) scores, the number of compressions of the analgesic pump, clinical efficacy and the occurrence of postoperative adverse reactions were compared between the two groups. Results The operation time, time of postoperative indwelling catheter and length of stay in hospital in the observation group were shorter than those in the control group, and the intraoperative blood loss and postoperative drainage volume in the observation group were less than those in the control group, with statistically significant differences between the two groups(P<0.05). The levels of forced vital capacity(FVC) and forced expiratory volume in 1 second(FEV1) after operation in the observation group were higher than those in the control group, and the levels of erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), and interleukin-6(IL-6) after operation in the observation group were lower than those in the control group, with statistically significant differences between the two groups(P<0.05). At 4 hours and 24 hours after operation, the VAS scores in the observation group were lower than those in the control group, and the number of compressions of the analgesic pump after operation in the observation group was less than that in the control group, with statistically significant differences between the two groups(P<0.05). The total clinical effective rate of the observation group was significantly higher than that of the control group(90.48% vs 73.68%; χ2=3.869, P=0.048), and the incidence of postoperative adverse reactions in the observation group was significantly lower than that in the control group(7.14% vs 23.68%; χ2=4.281, P=0.038). Conclusion Compared with the inflatable subxiphoid approach, the modified subxiphoid and subcostal incision procedure has less intraoperative blood loss, faster recovery for the patients, higher total clinical effective rate, and lower incidence of adverse reactions in resection of thymic tumors. The modified subxiphoid and subcostal incision procedure is worthy of clinical recommendation. |
| Key words: Modified subxiphoid and subcostal incision procedure Thymic tumor Inflatable subxiphoid approach Clinical efficacy Adverse reaction |
