CAJ | 학술논문

目的：探讨电视胸腔镜下治疗胸腺瘤的临床应用价值。方法将2008年7月至2013年4月确诊为胸腺瘤61例适合采用手术治疗的患者随机分为A组（胸腔镜组）31例和B组（传统手术组）30例。治疗后观察两组手术临床资料、肺功能、术后并发症、复发等方面指标。结果 A组在术中出血量、手术时间、切口长度方面均小于B组，A组胸管引流时间、引流量、住院时间、术后疼痛评分、止痛药物应用情况优于B组，两组比较差异具有显著性（ P <0.01）；A组治疗后在第1秒用力呼气量（FEV1）、最大呼气量（FVC）与治疗前比较无明显变化（ P >0.05），B组治疗后FEV1、FVC与疲劳指数（Fatigue index）较治疗前有明显下降（ P <0.05）；两组术后比较，A组FEV1、FVC高于B组，疲劳指数低于B组，具有显著性差异（ P <0.05）。A组上肢运动障碍发生率低于B组，差异具有显著性（ P <0.05）。两组并发症、复发或死亡发生情况差异无显著性（ P >0.05）。结论电视胸腔镜治疗胸腺瘤能达到与传统手术一样的疗效，具有切口小，并发症少，术后恢复快，具有和开胸组相当的近期肿瘤根治效果，是一种安全、可行、临床效果好的微创术式。
목적：탐토전시흉강경하치료흉선류적림상응용개치。방법장2008년7월지2013년4월학진위흉선류61례괄합채용수술치료적환자수궤분위A조（흉강경조）31례화B조（전통수술조）30례。치료후관찰량조수술림상자료、폐공능、술후병발증、복발등방면지표。결과 A조재술중출혈량、수술시간、절구장도방면균소우B조，A조흉관인류시간、인류량、주원시간、술후동통평분、지통약물응용정황우우B조，량조비교차이구유현저성（ P <0.01）；A조치료후재제1초용력호기량（FEV1）、최대호기량（FVC）여치료전비교무명현변화（ P >0.05），B조치료후FEV1、FVC여피로지수（Fatigue index）교치료전유명현하강（ P <0.05）；량조술후비교，A조FEV1、FVC고우B조，피로지수저우B조，구유현저성차이（ P <0.05）。A조상지운동장애발생솔저우B조，차이구유현저성（ P <0.05）。량조병발증、복발혹사망발생정황차이무현저성（ P >0.05）。결론전시흉강경치료흉선류능체도여전통수술일양적료효，구유절구소，병발증소，술후회복쾌，구유화개흉조상당적근기종류근치효과，시일충안전、가행、림상효과호적미창술식。
Objective To explore the clinical effect of thoracoscopic thymectomy in treatment of thymoma. Methods A total of 61 pa-tients with thymoma during June 2008 to April 2013 were randomly divided into group A(VATS group,n=31)and group B(trans-sternal open thymectomy group,n=30). The clinical data,postoperative complications and perioperative mortality of these patients were observed and com-pared. Results In comparison with group B,patients in group A had significantly shorter operating time,less blood loss,shorter postoperative hospitalization stay,shorter incision length,lower postoperative pain scores,less analgesic doses,shorter duration of chest tube drainage and less amount of chest drainage( P <0. 01). Index of fatigue in these two groups was significantly increased( P <0. 05). The FEV1 and FVC in group B had obvious change compared with those before treatment( P <0. 05),and they were significantly increased in control group compared with those of observation group( P <0. 05). The difference in postoperative FEV1,FVC and Fatigue index was significant( P <0. 05). Conclusion Thoracoscopic thymectomy is a safe,feasible,effective and minimally invasive procedure for treatment of thymoma,it has less complications and quick recovery and it also has similar short-term outcome with conventional open thymectomy.