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目的对胸腔镜与传统手术治疗老年胸腺瘤的临床情况和安全性进行比较分析,以体现胸腔镜治疗优越性。方法选取经CT或PET-CT确诊为胸腺瘤的患者92例,随机分为胸腔镜治疗组和传统手术治疗组各46例。术后记录两组患者的临床症状并进行随访。记录两组患者术中出血量、手术时间、术后止痛药使用情况,心肺功能恢复情况、住院时间和术后并发症,以及肿瘤复发和患者死亡情况。结果胸腔镜组患者术中出血量、手术时间、切口大小、止痛药使用情况、引流管留置时间和引流量,以及住院时间均较传统手术组少,明显优于传统手术组,差异具有统计学意义(P<0.05)。胸腔镜组患者术后并发症1例,不良反应1例;传统手术组患者术后并发症发生9例,不良反应7例,两组比较差异有统计学意义(P<0.05)。两组患者术后复发各1例,胸腔镜组6年内死亡1例,传统手术组死亡2例。肿瘤复发率和病死率两组差异均无统计学意义(P<0.05)。结论胸腔镜治疗老年胸腺瘤患者临床恢复情况好,术后并发症少,可推广成为老年胸腺瘤手术治疗的首选方法。
Objective To compare and analyze the clinical situation and safety of thoracoscopic and traditional surgical treatment of elderly thymoma in order to show the superiority of thoracoscopic treatment. Methods Totally 92 patients diagnosed as thymoma by CT or PET-CT were randomly divided into thoracoscope group and conventional surgery group, 46 cases each. The clinical symptoms of the two groups were recorded and followed up. The blood loss, operation time, pain medication use, recovery of cardiopulmonary function, hospitalization time and postoperative complications, as well as tumor recurrence and patient’s death were recorded. Results The intraoperative blood loss, operation time, incision size, analgesic usage, drainage tube indwelling time and drainage volume, and hospital stay in thoracoscopic group were significantly less than those in conventional surgery group, and the difference was statistically significant Significance (P <0.05). There were 1 case of postoperative complications and 1 case of adverse reactions in the thoracoscopic group. There were 9 cases of postoperative complications and 7 cases of adverse reactions in the conventional surgery group. There was significant difference between the two groups (P <0.05). One case was recurred in both groups, one case died in 6 years in thoracoscope group and 2 cases died in traditional operation group. Tumor recurrence rate and mortality were not significantly different between the two groups (P <0.05). Conclusion Thoracoscopic treatment of elderly patients with thymoma clinical recovery is good, less postoperative complications, can be promoted as the preferred method of surgical treatment of elderly thymoma.