两孔式胸腔镜肺叶切除术和传统三孔式胸腔镜肺叶切除术临床效果比较

发布时间：2019-03-09 13:35

【摘要】：目的：对比两孔式胸腔镜肺叶切除术（two port thoracoscopiclobectomy TPTL）与传统三孔式胸腔镜肺叶切除术（three portthoracoscopic lobectomy TTTL）的临床应用效果，阐述TPTL在临床治疗中的意义及价值。方法：回顾性分析行胸腔镜下肺叶切除的154例患者的临床资料，其中30例因合并高血压、冠心病、糖尿病和慢性支气管炎病史除外，余124例入组。按照其所行术式的不同分为TPTL组60例（采用TPTL、淋巴结廓清术），TTTL组（采用TTTL、淋巴结廓清术）64例，对比2组患者切口长度(TPTL组：观察孔+操作孔；TTTL组：观察孔+操作孔+副操作孔)、手术时间、术中出血量、术后盐酸哌替啶用量、术后拔除胸引管时间、术后住院时间、术后6个月患侧上肢活动后不适者的例数。结果：TPTL组患者切口长度为（4.0±0.2）cm，TTTL组患者切口长度为（6.2±0.3）cm(P＜0.05)。TPTL组患者术后盐酸哌替啶的用量为（125±35）mg，TTTL组患者术后盐酸哌替啶的用量（240±46）mg（P＜0.05）。TPTL组2例患者术后6个月患侧上肢活动后不适，，TTTL组11例患者术后6个月患侧上肢活动后不适（P＜0.05）。两组患者手术时间、术中出血量、术后拔除胸引管时间和术后住院日方面无统计学意义。结论：TPTL较TTTL可以减小切口长度、减轻术后疼痛、提高患者术后生活质量，具有较高的临床应用价值。
[Abstract]:Aim: to compare the clinical effects of two-orifice thoracoscopic lobectomy (two port thoracoscopiclobectomy TPTL) and traditional three-orifice thoracoscopic lobectomy (three portthoracoscopic lobectomy TTTL), and to discuss the significance and value of TPTL in clinical treatment. Methods: the clinical data of 154 patients undergoing thoracoscopic lobectomy were retrospectively analyzed. The remaining 124 patients were enrolled in the group except for the history of hypertension, coronary heart disease, diabetes mellitus and chronic bronchitis in 30 patients with hypertension, coronary heart disease, diabetes mellitus and chronic bronchitis. According to the type of operation, 60 cases were divided into TPTL group (), TTTL group with TPTL, lymph node dissection and 64 cases with TTTL, lymph node dissection). The incision length was compared between two groups (TPTL group: observation of orifice operation hole); In TTTL group, the operation time, the amount of bleeding during operation, the dosage of pethidine hydrochloride after operation, the time of extubation of thoracic drainage tube, the length of hospital stay after operation, and the number of patients who were unfit after upper limb movement 6 months after operation were observed. Results: the incision length of TPTL group was (4 0 卤0 2) cm,TTTL group, the incision length was (6 2 卤0 3) cm (P < 0 05). TPTL group, the dosage of pethidine hydrochloride was (125 卤35) mg, after operation. The dosage of pethidine hydrochloride in TTTL group (240 卤46) mg (P < 0. 05). TPTL) was significantly lower than that in TTTL group (P < 0. 05), and that in TTTL group was less than 6 months after operation (P < 0. 05), while that in TTTL group was less than 6 months after operation (P < 0. 05). There was no significant difference in operative time, intraoperative bleeding, extubation of thoracic catheterization and postoperative hospital stay between the two groups. Conclusion: compared with TTTL, TPTL can reduce the length of incision, relieve postoperative pain and improve the quality of life of patients after operation.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R655.3

【参考文献】