摘要
目的探讨胸腔镜胸腺切除术治疗重症肌无力合并胸腺瘤的临床疗效和预后。方法选取2014年4月至2017年3月在四川省乐山市人民医院行胸腺切除术的60例重症肌无力合并胸腺瘤患者,采用随机数字表法分为观察组和对照组,每组30例。对照组采用常规经胸骨开胸胸腺切除术,观察组采用胸腔镜胸腺切除术。比较两组患者的临床疗效及预后情况。结果术后随访1.0~2.0年,观察组临床治疗有效率为93.3%,与对照组(90.0%)比较差异无显著性(P>0.05)。观察组术中出血量及术后住院时间低于对照组,术后带管时间长于对照组,差异有显著性(P<0.05),但两组手术时间和术后引流量差异无显著性(P>0.05)。观察组术后并发症发生率为20.0%,与对照组(16.7%)比较差异无显著性(P>0.05)。两组术前生活质量评分差异无显著性(P>0.05),而观察组术后生活质量评分明显优于对照组,差异有显著性(P<0.05)。结论与常规开胸手术相比,胸腔镜胸腺切除术具有类似的临床疗效,且术中出血量更少,术后住院时间更短,值得临床推广。
Objective To investigate the clinical efficacy and prognosis of thoracoscopic thymectomy for myasthenia gravis complicated with thymoma.Method Sixty patients with myasthenia gravis complicated with thymoma who underwent thymectomy from Leshan City People’s Hospital in Sichuan Province from April 2014 to March 2017 were randomly divided into observation group and control group,30 cases in each group.The control group underwent conventional transthoracic thymectomy and the observation group underwent thoracoscopic thymectomy.The clinical efficacy and prognosis of the two groups were compared.Result The follow-up period was 1 to 2 years.The effective rate of clinical treatment was 93.3%in the observation group.There was no significant difference between the control group and the control group(90.0%)(P>0.05).The intraoperative blood loss and postoperative hospital stay in the observation group were lower than those in the control group.The postoperative tube length was longer than that of the control group,and the difference was significant(P<0.05).However,there was no significant difference between the operation time and postoperative drainage volume(P>0.05).The incidence of postoperative complications in the observation group was 20.0%,and there was no significant difference between the control group and the control group(16.7%)(P>0.05).There was no significant difference in preoperative quality of life scores between the two groups(P>0.05),while the postoperative quality of life scores in the observation group were significantly better than those in the control group(P<0.05).Conclusion Compared with conventional thoracotomy,thoracoscopic thymectomy has similar clinical efficacy,and the intraoperative blood loss is less,the postoperative hospital stay is shorter,which reduces the economic burden of patients and is worthy of clinical promotion.
作者
彭华利
周洋
郑波
唐仕海
赵飞
胡同晨
PENG Hua-li;ZHOU Yang;ZHENG Bo;TANG Shi-hai;ZHAO Fei;HU Tong-chen(Department of Cardiothoracic Surgery,People’s Hospital of Leshan,Sichuan Leshan 614000,China)
出处
《中国医刊》
CAS
2019年第11期1208-1210,共3页
Chinese Journal of Medicine
基金
四川省医学科研青年创新课题（Q17041）
