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目的探讨单肋间单操作孔电视胸腔镜胸腺切除术改善重症肌无力(MG)患者术后胸壁慢性疼痛的临床意义,以及其手术安全性与临床疗效。方法回顾性收集2010年1月至2012年12月第三军医大学大坪医院野战外科研究所胸外科行电视胸腔镜胸腺切除95例,对比分析经右胸前外侧径路胸腺切除(TVAT组)与单肋间单操作孔胸腔镜胸腺切除(VTSI组)的临床与随访资料。结果全组无围术期死亡。两组患者在手术时间、出血量、中转率及术后并发症、远期疗效等差异无统计学意义(P>0.05)。VTSI组患者术后急性疼痛及慢性胸壁疼痛明显低于TVAT组。结论单肋间单操作孔径路可减轻MG患者术后疼痛与胸壁感觉异常,安全可行。
Objective To investigate the clinical significance of single-hole single-hole video-assisted thoracoscopic thoracotomy in the treatment of postoperative chest wall pain in patients with myasthenia gravis (MG), as well as its safety and clinical efficacy. Methods A total of 95 patients underwent thoracotomy for thoracic surgery at the Department of Thoracic Surgery, Daping Hospital, Third Military Medical University from January 2010 to December 2012 were retrospectively analyzed. Thyroidectomy (TVAT group) and single Intercostal single-hole thoracoscopic thymus resection (VTSI group) clinical and follow-up data. Results There was no perioperative death in the whole group. There was no significant difference between the two groups in operation time, bleeding volume, transit rate, postoperative complications and long-term efficacy (P> 0.05). Postoperative acute pain and chronic chest wall pain were significantly lower in the VTSI group than in the TVAT group. Conclusion Single-intercavity single-access pathway can relieve postoperative pain and abnormal chest wall in patients with MG, which is safe and feasible.