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目的探讨胸腔镜和传统开胸手术治疗纵膈肿瘤的临床疗效。方法将110例纵隔肿瘤患者随机分为胸腔镜组和开胸手术治疗组,每组55例,比较两组患者的疗效和并发症发生率。结果两组均无手术死亡患者,胸腔镜组患者的术中出血量、术后下床活动时间和术后住院时间低于开胸手术治疗组(P<0.05),其刀口液化、肺不张以及肺部感染的发生率低于开胸手术治疗组(P<0.05)。两组患者术前与术后第1天皮质醇和促肾上腺皮质激素水平比较,差异无统计学意义(P>0.05),且两组均在术后第3天达到最高值,胸腔镜组低于开胸手术治疗组(P<0.05)。结论胸腔镜纵膈肿瘤切除术具有创伤小和应激反应轻的优点,达到与传统开胸手术同样的治疗效果。
Objective To investigate the clinical effects of thoracoscopy and conventional thoracotomy for the treatment of mediastinal tumors. Methods 110 patients with mediastinal tumor were randomly divided into thoracoscopic group and thoracotomy group, 55 cases in each group. The curative effect and complication rate of the two groups were compared. Results There was no surgical death in both groups. The amount of blood loss, postoperative ambulation and postoperative hospital stay in thoracoscopic group were significantly lower than those in thoracotomy group (P <0.05) And the incidence of pulmonary infection was lower than that of the thoracic surgery group (P <0.05). There was no significant difference in the levels of cortisol and adrenocorticotropic hormone between the two groups before and 1 day after operation (P> 0.05). Both groups reached the highest value on the 3rd day after operation, Thoracotomy group (P <0.05). Conclusions Thoracoscopic mediastinal tumor resection has the advantages of less trauma and less stress response, and achieves the same therapeutic effect as conventional thoracotomy.