本文選題：全胸腔鏡 + 肺葉切除術(shù)　； 參考：《福建醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的：通過臨床研究評價不同術(shù)式在完全電視胸腔鏡下（VATS）肺葉切除術(shù)治療效果，并探討VATS下肺葉切除術(shù)的可行性、安全性及其臨床意義，重點分析腔鏡肺葉切除術(shù)中血管處理技巧。 方法：收集2011年7月至2013年2月本組開展的全胸腔鏡肺葉切除手術(shù)104例，按手術(shù)方法分為王式手法組（54例）和單向式組（50例），比較兩組患者術(shù)中及術(shù)后近期效果。 結(jié)果：（1）兩組手術(shù)在肺葉切除后均行淋巴結(jié)清掃，王式手法組清掃淋巴結(jié)站數(shù)及數(shù)量分別為（4.4±0.6）站、（16.5±8.1）個，單向式組為（4.5±0.7）站、（17.1±7.8）個，兩者比較差異均無統(tǒng)計學(xué)意義（P＞0.05）。（2）兩組手術(shù)時間、術(shù)中出血量、術(shù)后當(dāng)日引流量、術(shù)后胸管保留時間、術(shù)后住院時間均相近，王式手法組分別為（146±61）min、（105±49）ml、（206±52）ml、（2.9±1.5）天，（5.2±1.9天），單向式組為（144±55）min、（104±57）ml、（211±49）ml，（2.7±1.7）天，（5.1±2.3）天，相比較差異無統(tǒng)計學(xué)意義（P＞0.05）。兩組住院總費用分別為（3.8±0.3）萬元、（3.7±0.5）萬元，比較差異無統(tǒng)計學(xué)意義（P＞0.05）。（3）兩組并發(fā)癥發(fā)生情況：王式手法組共5例出現(xiàn)并發(fā)癥，，并發(fā)癥發(fā)生率為9.3%；單向式組共4例發(fā)生并發(fā)癥，并發(fā)癥發(fā)生率為8.0%，兩組相比較無統(tǒng)計學(xué)意義，P＞0.05 結(jié)論：全胸腔鏡下肺葉切除術(shù)是一種安全、可行、微創(chuàng)的手術(shù)方式，應(yīng)予積極推廣。兩種手術(shù)方式在安全性、手術(shù)效果、住院時間、住院費用等方面無明顯差別，可根據(jù)術(shù)中情況選擇靈活選擇合適的方式以提高手術(shù)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 鹵8.1 in the Wang manipulation group and 17.1 鹵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 鹵61min, 206 鹵52ml, 2.9 鹵1.5, and 5.2 鹵1.9 days, respectively, and the one-way group was 144 鹵55min, 211 鹵49ml, 2.7 鹵1.7, 5.1 鹵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 鹵0.3 yuan and 3.7 鹵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.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R655.3

【參考文獻】

相關(guān)期刊論文 前10條

1 張長弓;巫正偉;李高峰;張勇;錢可寶;向旭東;郭剛;王巍煒;葉聯(lián)華;陳楠;;電視胸腔鏡輔助小切口肺葉切除44例臨床分析[J];腫瘤基礎(chǔ)與臨床;2010年04期

2 高從敬,陳爾瑜,蔡國君;肺癌組織內(nèi)血管密度的X線解剖學(xué)研究及其臨床意義[J];解剖與臨床;2005年02期

3 史躍;高從敬;曹志章;張南征;欒智勇;;肺癌支氣管動脈樹X線解剖及其臨床意義[J];解剖與臨床;2005年04期

4 史躍,高從敬;采用雙重介入治療中晚期肺癌的臨床研究[J];介入放射學(xué)雜志;2002年03期

5 林敏;涂遠(yuǎn)榮;李旭;賴繁彩;陳劍鋒;葉建剛;代祖建;;胸腔鏡輔助小切口肺癌根治術(shù)102例[J];中國癌癥雜志;2006年05期

6 高從敬,陳爾瑜,紀(jì)榮明;肺癌組織內(nèi)肺動脈灌注血管立體構(gòu)筑[J];中國腫瘤臨床;1999年07期

7 高從敬,葉福林,張南征,朱斌;肺癌組織內(nèi)肺動脈供血活體灌注觀察[J];中國臨床解剖學(xué)雜志;2005年01期

8 劉會平;;微創(chuàng)肺葉切除術(shù)臨床技巧[J];中國微創(chuàng)外科雜志;2006年09期

9 譚群友;王如文;蔣耀光;鄧波;馬錚;周景海;龔太乾;;全胸腔鏡肺葉切除術(shù)治療肺部疾病[J];中國胸心血管外科臨床雜志;2008年03期

10 劉彥國;王俊;李運;劉軍;李劍鋒;姜冠潮;趙輝;楊帆;卜梁;;內(nèi)鏡用直線切割縫合器在全胸腔鏡肺葉切除術(shù)中的應(yīng)用[J];中國胸心血管外科臨床雜志;2008年05期

本文編號：1933975