电视胸腔镜下胸腺扩大切除术治疗重症肌无力伴胸腺瘤的疗效及对生活质量的影响

发布时间：2018-06-19 02:33

本文选题：电视胸腔镜手术 + 胸腔扩大切除　；参考：《中国老年学杂志》2017年24期

【摘要】：目的探讨电视胸腔镜下胸腺扩大切除术治疗重症肌无力(MG)伴胸腺瘤的疗效及对生活质量的影响。方法选择95例MG伴胸腺瘤患者,按随机数字表法分为两组。治疗组47例行电视胸腔镜下胸腺扩大切除术,对照组48例行经胸腔胸腺扩大切除术,两组均切除胸腺和清扫前纵膈脂肪组织。比较两组术中出血量、手术切口长度、手术时间、术后胸腔引流时间、重症监护室(ICU)监护时间、术后住院时间及围术期并发症发生率。术后1年采用欧洲癌症研究和治疗组织的生活质量问卷(EORTC-QLQ)评估患者生活质量。结果治疗组手术切口长度显著短于对照组,术后胸腔引流时间、术中出血量、术后住院时间和ICU监护时间显著少于对照组(P0.05)。治疗组围术期未观察到并发症发生,明显低于对照组的10.42%(P0.05)。两组术后1年EORTC-QLQ各项评分均显著高于术前1 d(P0.05),但两组比较无统计学差异(P0.05)。结论电视胸腔镜下胸腺扩大切除术具有创口小、出血量少、术后恢复快、围术期并发症发生率低及改善术后患者生活质量等优点,可应用于MG伴胸腺瘤的治疗。
[Abstract]:Objective to evaluate the efficacy and quality of life (QOL) of extended thymectomy for myasthenia gravis with thymoma under video-assisted thoracoscopic surgery. Methods 95 patients with MG with thymoma were randomly divided into two groups. The treatment group (47 cases) underwent thoracoscopic thymectomy, while the control group (48 cases) underwent transthoracic thymectomy. The thymus was excised and the mediastinal adipose tissue was dissected in both groups. The amount of intraoperative bleeding, length of incision, time of operation, time of postoperative thoracic drainage, monitoring time of ICU in intensive care unit (ICU), postoperative hospitalization time and incidence of perioperative complications were compared between the two groups. The quality of life (QOL) was evaluated by EORTC-QLQ (European Organization for Cancer Research and treatment) 1 year after operation. Results the length of operative incision in the treatment group was significantly shorter than that in the control group, the time of postoperative thoracic drainage, intraoperative bleeding, postoperative hospitalization time and ICU monitoring time were significantly less than those in the control group (P 0.05). No complications were observed in the treatment group during perioperative period, which was significantly lower than that in the control group (10.42%, P 0.05). The scores of EORTC-QLQ in the two groups were significantly higher than those in the first day after operation (P 0.05), but there was no significant difference between the two groups (P 0.05). Conclusion enlarged thymectomy under video-assisted thoracoscopic surgery has the advantages of small wound, less bleeding, quick recovery, low incidence of perioperative complications and improvement of the quality of life of the patients after operation. It can be used in the treatment of MG with thymoma.
【作者单位】：安徽医科大学第一附属医院胸外科;
【分类号】：R736.3;R746.1

【相似文献】