全胸腔镜下行肺叶切除术104例临床研究

发布时间：2018-05-25 16:59

本文选题：全胸腔镜 + 肺叶切除术　；参考：《福建医科大学》2013年硕士论文

【摘要】：目的：通过临床研究评价不同术式在完全电视胸腔镜下（VATS）肺叶切除术治疗效果，并探讨VATS下肺叶切除术的可行性、安全性及其临床意义，重点分析腔镜肺叶切除术中血管处理技巧。方法：收集2011年7月至2013年2月本组开展的全胸腔镜肺叶切除手术104例，按手术方法分为王式手法组（54例）和单向式组（50例），比较两组患者术中及术后近期效果。结果：（1）两组手术在肺叶切除后均行淋巴结清扫，王式手法组清扫淋巴结站数及数量分别为（4.4±0.6）站、（16.5±8.1）个，单向式组为（4.5±0.7）站、（17.1±7.8）个，两者比较差异均无统计学意义（P＞0.05）。（2）两组手术时间、术中出血量、术后当日引流量、术后胸管保留时间、术后住院时间均相近，王式手法组分别为（146±61）min、（105±49）ml、（206±52）ml、（2.9±1.5）天，（5.2±1.9天），单向式组为（144±55）min、（104±57）ml、（211±49）ml，（2.7±1.7）天，（5.1±2.3）天，相比较差异无统计学意义（P＞0.05）。两组住院总费用分别为（3.8±0.3）万元、（3.7±0.5）万元，比较差异无统计学意义（P＞0.05）。（3）两组并发症发生情况：王式手法组共5例出现并发症，，并发症发生率为9.3%；单向式组共4例发生并发症，并发症发生率为8.0%，两组相比较无统计学意义，P＞0.05 结论：全胸腔镜下肺叶切除术是一种安全、可行、微创的手术方式，应予积极推广。两种手术方式在安全性、手术效果、住院时间、住院费用等方面无明显差别，可根据术中情况选择灵活选择合适的方式以提高手术安全性和便捷性。
[Abstract]:Objective: to evaluate the efficacy of different surgical procedures in the treatment of pulmonary lobectomy with complete video-assisted thoracoscopy (VATS), and to explore the feasibility, safety and clinical significance of lobectomy under VATS. The techniques of vascular management in endoscopic lobectomy were analyzed. Methods: 104 cases of total thoracoscopic lobectomy were collected from July 2011 to February 2013. According to the operative methods, they were divided into two groups: the Wang manipulation group (n = 54) and the one-way group (n = 50). The results of operation and operation were compared between the two groups. Results the two groups underwent lymph node dissection after lobectomy. The number and number of lymph nodes were 16.5 卤8.1 in the Wang manipulation group and 17.1 卤7.8 in the one-way group respectively. There was no significant difference between the two groups (P > 0.05. The volume of bleeding during operation, the drainage flow on the day after operation, the time of retaining the thoracic duct after operation, and the time of hospitalization after operation were all similar. In the Wang type manipulation group, the blood loss was 105 卤61min, 206 卤52ml, 2.9 卤1.5, and 5.2 卤1.9 days, respectively, and the one-way group was 144 卤55min, 211 卤49ml, 2.7 卤1.7, 5.1 卤2.3 days, respectively. There was no significant difference between the two groups (P > 0.05). The total hospitalization cost of the two groups was 3.8 卤0.3 yuan and 3.7 卤0.5 thousand yuan, respectively. There was no significant difference in the occurrence of complications between the two groups (P > 0.05, P > 0.05, P > 0.05). The incidence of complications in the Wang type manipulation group was 9. 3%, and that in the unidirectional group was 9. 3%. The incidence of complications was 8.0 and there was no significant difference between the two groups (P > 0.05). Conclusion: total thoracoscopic lobectomy is a safe, feasible and minimally invasive method, which should be popularized actively. There were no significant differences in safety, surgical effect, hospital stay and hospitalization cost between the two types of operation, so we can choose a suitable way according to the condition of operation to improve the safety and convenience of the operation.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R655.3

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