不同手术方法治疗原发性纵隔肿瘤的效果比较.docVIP

不同手术方法治疗原发性纵隔肿瘤的效果比较 　　作者：邓海青，杜正隆，钟齐庆 作者单位：(广西钦州市第二人民医院心胸外科，广西钦州535000) 　　【摘要】 目的 探讨应用不同方法治疗原发性纵隔肿瘤的临床意义。方法 48例原发性纵隔肿瘤患者行电视胸腔镜辅助切除手术(VATS组)26例和传统经胸骨正中切口开胸手术(开胸组)22例，比较两组患者围手术期相关临床观察指标。结果 两组均无围手术期死亡病例，VATS组术中出血量比开胸组减少，术后住院时间比开胸组缩短(P均0.01)。结论 VATS同样可取得与传统开胸切除术的清除效果，且创伤小、恢复快、住院时间短，可作为原发性纵隔肿瘤的重要治疗手段。 　　【关键词】 纵隔肿瘤;胸外科手术，电视辅助;开放手术 　　A comparison of the efficacy among different surgical programs in treatment of primary mediastinal tumor 　　DENG Hai-qing, DU Zheng-long,Zhong Qi-qing 　　(Department of Cardiothoracic Surgery, The Second Peoples Hospital of Qinzhou,Qinzhou, Guangxi 535000,China) 　　Abstract: Objective To outline clinical significances of different surgical programs in treatment of primary mediastinal tumor. Methods 48 cases of primary mediastinal tumors enrolled in this study. 26 of them underwent video-assisted thoracoscopic surgery (VATS group) and 22 of them underwent conventional thoracic surgery in median incision percutaneous sternum (thoracotomy group). To compare of the clinical indicators in perioperative period between the two groups. Results No death occurred in perioperative period in the two groups. In VATS group the volume of bleeding was less and the hospitalized time was shorter, compared to the thoracotomy group, there were statistically significant differences (P0.01). Conclusion VATS has advantages of minimal invasiveness, quicker recovery,shorter hospitation time and can also be achieved clearing effects as open surgery, it can be used as an important program for primary mediastinal tumor. 　　Key words: mediastinal neoplasms; thoracic surgery, video-assisted; open surgery 　　原发性纵隔肿瘤是临床心胸外科常见的病变，一经发现多需手术切除治疗。笔者回顾性分析2001年2月～2009年12月期间我院行电视胸腔镜手术(VATS)切除术的原发性纵隔肿瘤患者26例，并与同期22例行传统开胸切除的患者进行比较，旨在初探胸腔镜在原发性纵隔肿瘤治疗的价值，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　入选病例为2001年2月～2009年12月期间在我院就诊的原发性纵隔肿瘤患者48例，其中男27例，女21例，年龄18～75岁，平均45.7岁。大多数病人均有不同程度的咳漱、胸闷、活动后气促、胸部隐痛等，无症状者因其他疾病就诊或体格检查发现有纵隔肿物。直径8cm以上巨大纵隔肿瘤4例，伴有颈静脉怒张2例，气管移位1例。病理检查：畸胎瘤17