胸腔镜前纵隔肿瘤切除术后不留置引流管的安全性探讨

【摘要】 目的 探讨经剑突下胸腔镜前纵隔肿瘤切除术后不留置引流管的安全性。方法 选取2014年6月至2018年5月行经剑突下胸腔镜前纵隔肿瘤切除术的患者39例,随机分为观察组20例(不留置胸腔引流管)与对照组19例(留置胸腔引流管),比较两组患者手术时间、术中出血量、术后疼痛评分、术后住院时间、术后并发症情况。结果 所有入组患者手术顺利,术后病理诊断胸腺瘤28例、胸腺增生4例、胸腺囊肿3例、畸胎瘤3例、心包源性囊肿1例。术后均无肺部感染、心脑血管意外、脏器功能衰竭等严重并发症,对照组中2例患者术后引流管口愈合延期。两组手术时间、术中出血量比较差异无统计学意义(P>0.05);观察组术后疼痛评分比对照组明显降低,术后住院时间明显缩短,差异有统计学意义(P<0.05)。结论 经剑突下胸腔镜前纵隔肿瘤切除术后不留置引流管对患者创伤小,患者术后恢复快,住院时间短,术后满意度高,更具有临床安全性与实用性。更多还原

【Abstract】 Objective To investigate the safety and practicability of non-drainage tube after anterior mediastinal tumor resection by subxyphoid approach video-assisted thoracoscopic surgery.Methods Thirty-nine patients with anterior mediastinal tumor from June 2014 to May 2018 were divided into two groups:The observation group(n=20)was left with a drainage tube after surgery and the control group(n=19)with no drainage tube left after surgery.The operative time,intraoperative blood loss,postoperative pain score,hospitalization time and postoperative complications of the two groups were compared and evaluated.Results All patients underwent successful surgery without serious complications.Postoperative pathological diagnosis showed that there were 28 cases of thymoma,4 cases of thymic hyperplasia,3 cases of thymic cyst,3 cases of teratoma and 1 case of pericardial cyst.The postoperative drainage tube wound healing was delayed in 2 patients in the control group.There was no significant difference between two groups in operative time and intraoperative blood loss(P>0.05).But the postoperative pain score of the observation group was significantly lower than the other group,the postoperative hospitalization time was significantly shorten(P<0.05).Conclusion The research shows,compared to traditional surgery,the patients with non-drainage tube after anterior mediastinal tumor resection by subxyphoid approach video-assisted thoracoscopic surgery are associated with shorter postoperative hospitalization time and lower rates of complications or postoperative pain score,it has clinical practicability and safety.更多还原