中华解剖与临床杂志
中華解剖與臨床雜誌
중화해부여림상잡지
Chinese Journal of Anatomy and Clinics
2015年
3期
241-244
,共4页
梁书增%程辉%周谦让%张雪梅
樑書增%程輝%週謙讓%張雪梅
량서증%정휘%주겸양%장설매
胸外科手术%胸部肿瘤%胸部疾病%腋下垂直小切口%保留胸肌切口
胸外科手術%胸部腫瘤%胸部疾病%腋下垂直小切口%保留胸肌切口
흉외과수술%흉부종류%흉부질병%액하수직소절구%보류흉기절구
Thoracic surgical procedures%Thoracic neoplasms%Thoracic diseases%Subaxillary vertical small incision%Muscle-sparing thoracotomy
目的：探讨保留胸肌腋下垂直小切口( MSVI)在开胸手术中的临床应用价值。方法回顾性分析2011年3月—2013年5月淮北市人民医院胸外科行开胸手术的81例患者的临床资料,按手术切口不同,分为MSVI组44例和传统后外侧切口组(传统组)37例,比较2组患者的手术切口长度、手术时间、术中出血量、术后胸引管留置时间、术后离床活动时间、住院时间、术后镇痛药用量和术后并发症等情况。采用t检验、χ2检验对数据进行统计分析。结果2组患者均顺利完成手术。MSVI组术后患者手术切口长度(10.64±1.43) cm、术后离床活动时间(1.14±0.47) d、住院时间(9.16±1.89)d、曲马多用量(160.23±45.21)mg,均少于传统组[分别为(21.95±2.50)cm、(2.36±0.71)d、(12.22±1.90)d和(274.32±66.27)mg],差异均有统计学意义(P值均<0.05)。 MSVI组和传统组患者手术时间[(115.14±43.42) min vs (112.97±35.76) min]、术中出血量[(168.11±75.28)mL vs (182.22±78.54)mL]、胸引管留置时间[(3.66±1.27)d vs(4.05±1.51)d]和术中、术后总并发症发生率比较[27.3%(12/44) vs 32.4%(12/37)],差异均无统计学意义(P值均>0.05)。结论 MSVI开胸手术能够减少胸部手术的创伤,患者术后疼痛轻、恢复快,安全可行。
目的：探討保留胸肌腋下垂直小切口( MSVI)在開胸手術中的臨床應用價值。方法迴顧性分析2011年3月—2013年5月淮北市人民醫院胸外科行開胸手術的81例患者的臨床資料,按手術切口不同,分為MSVI組44例和傳統後外側切口組(傳統組)37例,比較2組患者的手術切口長度、手術時間、術中齣血量、術後胸引管留置時間、術後離床活動時間、住院時間、術後鎮痛藥用量和術後併髮癥等情況。採用t檢驗、χ2檢驗對數據進行統計分析。結果2組患者均順利完成手術。MSVI組術後患者手術切口長度(10.64±1.43) cm、術後離床活動時間(1.14±0.47) d、住院時間(9.16±1.89)d、麯馬多用量(160.23±45.21)mg,均少于傳統組[分彆為(21.95±2.50)cm、(2.36±0.71)d、(12.22±1.90)d和(274.32±66.27)mg],差異均有統計學意義(P值均<0.05)。 MSVI組和傳統組患者手術時間[(115.14±43.42) min vs (112.97±35.76) min]、術中齣血量[(168.11±75.28)mL vs (182.22±78.54)mL]、胸引管留置時間[(3.66±1.27)d vs(4.05±1.51)d]和術中、術後總併髮癥髮生率比較[27.3%(12/44) vs 32.4%(12/37)],差異均無統計學意義(P值均>0.05)。結論 MSVI開胸手術能夠減少胸部手術的創傷,患者術後疼痛輕、恢複快,安全可行。
목적：탐토보류흉기액하수직소절구( MSVI)재개흉수술중적림상응용개치。방법회고성분석2011년3월—2013년5월회북시인민의원흉외과행개흉수술적81례환자적림상자료,안수술절구불동,분위MSVI조44례화전통후외측절구조(전통조)37례,비교2조환자적수술절구장도、수술시간、술중출혈량、술후흉인관류치시간、술후리상활동시간、주원시간、술후진통약용량화술후병발증등정황。채용t검험、χ2검험대수거진행통계분석。결과2조환자균순리완성수술。MSVI조술후환자수술절구장도(10.64±1.43) cm、술후리상활동시간(1.14±0.47) d、주원시간(9.16±1.89)d、곡마다용량(160.23±45.21)mg,균소우전통조[분별위(21.95±2.50)cm、(2.36±0.71)d、(12.22±1.90)d화(274.32±66.27)mg],차이균유통계학의의(P치균<0.05)。 MSVI조화전통조환자수술시간[(115.14±43.42) min vs (112.97±35.76) min]、술중출혈량[(168.11±75.28)mL vs (182.22±78.54)mL]、흉인관류치시간[(3.66±1.27)d vs(4.05±1.51)d]화술중、술후총병발증발생솔비교[27.3%(12/44) vs 32.4%(12/37)],차이균무통계학의의(P치균>0.05)。결론 MSVI개흉수술능구감소흉부수술적창상,환자술후동통경、회복쾌,안전가행。
Objective To assess the clinical value of muscle-sparing subaxillary vertical small incision in thoracotomy. Methods Clinical data of 81 patients with thoracotomy treated in the People’s Hospital of Huaibei City from March 2011 to May 2013 were retrospectively analyzed. The patients were divided into subaxillary vertical small incision grourp ( 44 patients ) and conventional surgery group ( 37 patients) according to the surgerytype. Incision length, operative time, blood loss, the incidence of postoperation pull out the chest tube, get out of bed time, length of stay, the dosage of analgesic and postoperative complications of postoperative patient were compared. The data were analyzed using t test andχ2 test. Results The patients were successfully comperformed surgery. MSVI group of patients with incision length(10.64 ±1.43)cm, postoperative bed stay (1.14 ±0.47)d, hospitalizational days(9.16 ±1.89)d and the dosage of tramadol(160. 23 ± 45. 21) mg were obviously shorter than conventional posterolateral thoracotomy with(21. 95 ± 2. 50) cm, (2. 36 ± 0. 71) d, (12. 22 ± 1. 90) d and (274. 32 ± 66. 27) mg, respectively(all P values<0. 05). Compared with the conventional posterolateral thoracotomy, the acute and chronic postoperative pain in study group were improved. No difference was observed between two groups in time for operation[(115. 14 ± 43. 42) min vs( 112. 97 ± 35. 76) min], the intraopetative blood lose [(168.11 ±75.28)mL vs( 182.22 ±78.54)mL], drainage tube retention[(3.66 ±1.27)d vs( 4.05 ± 1. 51)d],intraoperative and postoperative overall complications [27. 3%(12/44) vs 32. 4%(12/37)] (all P values>0. 05). Conclusions MSVI thoracotomy can reduce the damage of thoracotomy , postoperative pain, and can speed up postoperative recovery of patients, it is safe and feasible.
