腹腔镜三孔法剑突下3 cm切口入路与肋间隙入路在原发性纵膈肿瘤患者中的应用

doi:10.3760/cma.j.cn441417-20241212-17019

国际医药卫生导报 ›› 2025, Vol. 31 ›› Issue (17): 2917-2921.DOI: 10.3760/cma.j.cn441417-20241212-17019

腹腔镜三孔法剑突下3 cm切口入路与肋间隙入路在原发性纵膈肿瘤患者中的应用

贾永¹ 王榕² 樊艳婷³

¹宝鸡市中心医院胸外科，宝鸡 721000；²宝鸡市中医医院肿瘤血液科，宝鸡 721000；³西北大学附属西安国际医学中心医院输血科，西安 710010

收稿日期:2024-12-12 出版日期:2025-09-01 发布日期:2025-09-25
通讯作者: 王榕，Email：519best163.com
基金资助:
国家自然科学基金（82202550）

Application of laparoscopic three-hole subxiphoid 3 cm incision approach and intercostal space approach in patients with primary mediastinal tumors

Jia Yong¹, Wang Rong², Fan Yanting³

¹Department of Thoracic Surgery, Baoji Central Hospital, Baoji 72100,China; ²Department of Oncology and Hematology, Baoji Hospital of Traditional Chinese Medicine, Baoji 72100,China; ³Blood Transfusion Department, Northwest University Affiliated Xi'an International Medical Center Hospital, Xi'an 710010,China

Received:2024-12-12 Online:2025-09-01 Published:2025-09-25
Contact: Wang Rong, Email: 519best163.com
Supported by:
National Natural Science Foundation of China (82202550)

摘要/Abstract

摘要：

目的　探究腹腔镜三孔法剑突下3 cm切口入路与肋间隙入路对原发性纵膈肿瘤患者临床干预效果的影响。方法　选取宝鸡市中心医院2019年12月至2022年12月接收的98例原发性纵膈肿瘤患者，将其按照01～98的顺序编号，依据奇偶数列分组法分为对照组和干预组。对照组为奇数（49例），给予传统肋间隙入路治疗方案；干预组为偶数（49例），联合给予腹腔镜三孔法剑突下3 cm切口入路治疗方案。观察对比术前、术后两组患者血清疼痛应激因子、肺功能、生存情况等指标。统计学方法采用t检验、χ²检验。结果　术后7 d，干预组患者缓激肽（BK）、5-羟色胺（5-HT）、神经肽Y（NPY）均低于对照组［（3.86±0.06）μg/L比（3.93±0.05）μg/L、（340.48±14.54）μg/L比（353.59±12.61）μg/L、（119.36±3.42）ng/L比（126.55±4.23）ng/L］，差异均有统计学意义（t=6.274、4.768、9.253，均P<0.05）；术后3个月，干预组患者用力肺活量（FVC）、肺活量（VC）、最大通气量（MVV）、肺总量（TLC）肺功能均高于对照组，差异均有统计学意义（t=2.048、2.283、2.813、2.646，均P<0.05）。随访24个月，干预组死亡3例（6.12%），存活46例（93.88%），中位总生存期（OS）为16个月；对照组死亡9例（18.37%），存活40例（81.63%），OS为12个月，差异有统计学意义（χ²=5.089，P<0.05）。结论　对原发性纵膈肿瘤患者给予腹腔镜三孔法剑突下3 cm切口入路治疗方案，能减轻患者疼痛应激水平，增强肺部功能，提高患者生存质量。

关键词:

腹腔镜, 原发性纵膈肿瘤, 剑突, 肋间隙, 疼痛应激因子, 肺功能, 生存质量

Abstract:

Objective　To explore the impact of the three-port laparoscopic approach through the subxiphoid 3 cm incision and the intercostal space approach on the clinical intervention effects of patients with primary mediastinal tumors. Methods　A total of 98 patients with primary mediastinal tumors who were admitted to Baoji Central Hospital from December 2019 to December 2022 were selected. They were numbered in sequence from 01 to 98, and were divided into the control group and the intervention group according to the odd-even number grouping method.The control group consisted of odd numbers (49 cases) and was treated with the traditional intercostal space approach. The intervention group consisted of an even number (49 cases), and they were all treated with the laparoscopic three-port approach via a 3 cm incision under the xiphoid process.The preoperative and postoperative levels of serum pain stress factors, lung function, and survival conditions of the two groups of patients were observed and compared.Statistical methods employed t-test and χ² test. Results　Seven days after the operation, the levels of bradykinin (BK), 5-hydroxytryptamine (5-HT), and neuropeptide Y (NPY) in the intervention group were all lower than those in the control group [(3.86±0.06) μg/L vs.(3.93±0.05) μg/L,(340.48±14.54) μg/L vs.(353.59±12.61) μg/L,(119.36±3.42) ng/L vs.(126.55±4.23) ng/L], the differences were all statistically significant (t=6.274,4.768,9.253; all P<0.05). Three months after the operation, the forced vital capacity (FVC), vital capacity (VC), maximal ventilation volume (MVV), and total lung capacity (TLC) of the intervention group were all higher than those of the control group, and the differences were statistically significant (t=2.048,2.283,2.813,2.646; all P<0.05). After a 24-month follow-up, 3 patients (6.12%) in the intervention group died, while 46 patients (93.88%) survived. The median overall survival (OS) was 16 months. n the control group, 9 patients (18.37%) died and 40 patients (81.63%) survived. The overall survival (OS) time was 12 months, and the difference was statistically significant (χ²=5.089,P<0.05). Conclusion　For patients with primary mediastinal tumors, adopting the laparoscopic three-port approach via a 3 cm incision under the xiphoid process can alleviate the pain stress level of the patients, enhance their lung function, and improve their quality of life.

Key words:

Laparoscope, Primary mediastinal tumor, Xiphoid process, Intercostal space, Pain stress factor, Lung function, Quality of life

贾永王榕樊艳婷.

腹腔镜三孔法剑突下3 cm切口入路与肋间隙入路在原发性纵膈肿瘤患者中的应用 [J]. 国际医药卫生导报, 2025, 31(17): 2917-2921.

Jia Yong, Wang Rong, Fan Yanting.

Application of laparoscopic three-hole subxiphoid 3 cm incision approach and intercostal space approach in patients with primary mediastinal tumors [J]. International Medicine and Health Guidance News, 2025, 31(17): 2917-2921.

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腹腔镜三孔法剑突下3 cm切口入路与肋间隙入路在原发性纵膈肿瘤患者中的应用

Application of laparoscopic three-hole subxiphoid 3 cm incision approach and intercostal space approach in patients with primary mediastinal tumors

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