摘要
目的探讨胸腔镜剑突下纵隔肿物切除和胸腔镜侧胸切除对中性粒细胞百分比(NEUT%)、热休克蛋白90(Hsp90α)的影响。方法回顾选取阜阳市人民医院2020年3月至2024年10月行胸腔镜辅助纵隔肿物切除术的患者共153例,按照纳排标准剔除病例17例,最终纳入病例136例,按照不同入路方法分为A组(采用剑突下入路切除)62例和B组(采用侧胸入路切除)74例。比较两组手术情况及术后不同时间疼痛程度[视觉模拟评分(VAS)评分];比较术前、术后1 d应激指标[神经肽Y(NPY)、促肾上腺皮质激素(ACTH)、血管紧张素Ⅱ(AngⅡ)]、NEUT%、Hsp90α及术后并发症差异。结果两组手术时间比较,差异无统计学意义(P>0.05);与B组比较,A组术后4 h、24 h、48 h的VAS评分及术中失血量、术后引流量更低,住院时间更短,差异有统计学意义(P<0.05);术后1 d,A组NPY、ACTH、AngⅡ及NEUT%、Hsp90α水平均低于B组,差异有统计学意义(P<0.05);A组并发症发生率均低于B组,差异有统计学意义(P<0.05)。结论和胸腔镜侧胸切除比较,胸腔镜剑突下纵隔肿物切除术能够明显减少手术创伤,降低NEUT%、Hsp90α水平,术后疼痛、应激更轻,有利于术后恢复。
Objective To investigate the effects of thoracoscopic subxiphoid mediastinal tumor re⁃section and thoracoscopic lateral thoracic resection on neutrophil percentage(NEUT%)and heat shock protein 90(Hsp90α).Methods A total of 153 patients who underwent thoracoscopic⁃assisted mediastinal tumor resec⁃tion at Fuyang People's Hospital from March 2020 to October 2024 were retrospectively selected.According to the inclusion and exclusion criteria,17 cases were excluded,leaving 136 cases included in the study.These cases were then divided into two groups:group A,consisting of 62 cases resected by the subxiphoid approach,and group B,consisting of 74 cases resected by the lateral thoracic approach.The operation conditions and pain levels(measured by the visual analogue scale(VAS)score)at different times after the operation were compared be⁃tween the two groups.Stress indicators(neuropeptide Y(NPY),adrenocorticotropic hormone(ACTH),angio⁃tensinⅡ(AngⅡ),NEUT%,Hsp90α,and postoperative complications were also compared before and one day after the operation.Results There was no significant difference in operation time between the two groups(P>0.05).Compared to group B,group A had lower VAS scores at 4 h,24 h,and 48 h after the operation,as well as lower intraoperative blood loss,postoperative drainage volume and hospitalization time.These differences were statistically significant(P<0.05).One day after the operation,levels of NPY,ACTH,AngⅡ,NEUT%,and Hsp90αin group A were lower than those in group B.The difference was statistically significant(P<0.05).The incidence of complications in group A was also lower than in group B,with a statistically significant difference(P<0.05).Conclusion Compared to thoracoscopic lateral thoracotomy,thoracoscopic subxiphoid mediastinal tumor resection can significantly reduce surgical trauma.It also decreases NEUT%and Hsp90αlevels,resulting in lighter postoperative pain and stress.This is beneficial for postoperative recovery.
作者
李文彬
杨兵
王鑫洋
LI Wenbin;YANG Bing;WANG Xinyang(Department of Thoracic Surgery,Fuyang City People's Hospital,Fuyang,Anhui,China,236000)
出处
《分子诊断与治疗杂志》
2025年第8期1465-1467,1471,共4页
Journal of Molecular Diagnostics and Therapy
基金
安徽省卫生健康委科研项目(AHWJ2021b070)。
关键词
纵膈肿物
胸腔镜
剑突下切除
侧胸切除
中性粒细胞百分比
热休克蛋白90
Mediastinal mass
Thoracoscope
Subxiphoid resection
Lateral chest resection
Per⁃centage of neutrophils
Heat shock protein 90
作者简介
通信作者:李文彬,E⁃mail:zyf13955889906@163.com。
