林经纬

【摘要】 目的：分析接受前纵隔肿瘤切除治疗的患者接受剑突下单孔胸腔镜手术治疗的实际效果。方法：选择笔者所在医院2017年2月-2019年7月收治的46例前纵隔肿瘤患者为研究对象，将其随机均分为参照组与研究组，参照组接受三孔胸腔镜手术治疗，研究组接受剑突下单孔胸腔镜治疗。观察两组治疗前后疼痛情况、治疗后临床指标、患者满意度情况及并发症发生情况。结果：治疗前两组VAS评分比较差异无统计学意义（P>0.05），治疗后两组评分均降低，且研究组低于参照组，差异均有统计学意义（P<0.05）。研究组治疗后血清缓激肽、5-羟色胺均低于参照组，术后引流量少于参照组，置管时间短于参照组，差异均有统计学意义（P<0.05）。两组治疗后并发症发生率比较差异无统计学意义（P>0.05）。研究组治疗总满意度高于参照组，差异有统计学意义（P<0.05）。結论：对于前纵隔肿瘤患者的治疗方式选择而言，让其接受剑突下单孔胸腔镜手术治疗的效果较好，该方案值得推广。

【关键词】 前纵隔肿瘤 三孔胸腔镜 单孔胸腔镜 并发症 VAS评分

doi：10.14033/j.cnki.cfmr.2019.30.002 文献标识码 A 文章编号 1674-6805（2019）30-000-03

[Abstract] Objective： To analyze the actual effect of single-hole thoracoscopic surgery under xiphoid surgery in patients undergoing anterior mediastinal tumor resection. Method： Forty-six patients with anterior mediastinal tumor who were admitted to our hospital from February 2017 to July 2019 were enrolled in the study. They were randomly divided into the reference group and the study group. The control group received three-hole thoracoscopic surgery， and the study group received subsagittal single-hole thoracoscopy. The subjects in the study group were treated with single-hole thoracoscopic surgery under the xiphoid process. The pain before and after treatment， the clinical indicators after treatment， the patients satisfaction and complications were observed. Result： There was no statistically significant difference in VAS scores between the two groups before treatment （P>0.05）. The scores of the two groups decreased after treatment， and the study group was lower than the reference group， the differences were statistically significant （P<0.05）. After treatment， the serum bradykinin and serotonin in the study group were lower than those in the control group， the postoperative drainage volume was less than that in the control group， and the catheterization time was shorter than that in the control group （P<0.05）. There was no significant difference in the incidence of complications between the two groups （P>0.05）. The total satisfaction rate of the study group was higher than that of the control group， the difference was statistically significant （P<0.05）. Conclusion： For the treatment options of patients with anterior mediastinal tumor， it is better to receive single-hole thoracoscopic surgery under xiphoid surgery. This program is worthy of promotion.

[Key words] Anterior mediastinal tumor Three-hole thoracoscopic Single-hole thoracoscopic Complications VAS score

First-authors address： Fuzhou Second Hospital Affiliated to Xiamen University， Fuzhou 350007， China

前纵隔肿瘤是一种临床当中相对较为常见的肿瘤疾病，患者类型主要分为原发性与转移性两种，其中，多以转移性肿瘤患者更为多见[1]。患有前纵隔肿瘤的患者主要症状体现为干咳、气喘、吞咽障碍等，且患者上胸部与颈部会出现不同程度的水肿，这会给患者的身心健康、生活质量带来不利影响[2-3]。前纵隔肿瘤患者一般都需要接受手术治疗，医生需要将患者的肿瘤尽快切除，从而改善患者的健康状况[4-5]。但是，前纵隔肿瘤的所在位置相对较为特殊，医生在手术过程中也会遇到不同的问题，因此，针对前纵隔肿瘤患者选择更为高效、安全的手术方式十分关键[6-7]。笔者所在医院针对此类患者分别选择两种类型的术式进行治疗，现结合具体情况论述如下。