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目的探讨控制性降压在3cm单孔胸腔镜下左侧肺癌根治术第7组淋巴结清扫中应用的可行性及临床效果。方法回顾性分析2015年5~8月华中科技大学附属同济医院胸外科行3cm单孔胸腔镜下左侧肺癌根治术37例患者的临床资料。其中12例患者在术中行第7组淋巴结节清扫时采用硝酸甘油或硝普钠将收缩压控制在80~90 mm Hg左右,并与同期未行控制性降压的25例患者进行对比。试验组中,男7例、女5例,平均年龄58.3(42~69)岁。对照组中,男14例、女11例,平均年龄57.7(43~68)岁。两组患者既往无高血压及心脑血管病史。结果控制性降压在第7组淋巴结节清扫时取得了满意的效果,清扫时间15.6~25.3(18.5±4.3)min,同期对照组清扫时间18.2~29.8(24.3±5.1)min,差异有统计学意义(P<0.05)。结论 3cm单孔胸腔镜术中控制性降压有助于降低第7组淋巴结清扫难度,减少出血风险,不增加术后并发症,是简易可行的方法。
Objective To investigate the feasibility and clinical effect of controlled hypotension in lymph node dissection in group 7 with single-hole thoracoscopic surgery for left lung cancer. Methods The clinical data of 37 patients undergoing 3 cm single hole thoracoscopic left lung cancer radical mastectomy in Department of Thoracic Surgery, Tongji Hospital, Huazhong University of Science and Technology from May to August 2015 were retrospectively analyzed. Twelve of these patients underwent nystagmus or nitroprusside during the operation of group 7 lymphadenectomy to control systolic blood pressure at about 80-90 mm Hg and compared with 25 patients who underwent uncontrolled hypotension during the same period. Test group, 7 males and 5 females, average age 58.3 (42 ~ 69) years old. Control group, 14 males and 11 females, with an average age of 57.7 (43 ~ 68) years old. Two groups of patients without previous history of hypertension and cardiovascular disease. Results Controlled antihypertensive achieved satisfactory results in group 7 lymph node dissection with a mean time between 15.6 and 25.3 (18.5 ± 4.3) min and between 18.2 and 29.8 (24.3 ± 5.1) min in the control group Significance (P <0.05). Conclusions Controlled hypotension in 3cm single-hole thoracoscopic surgery is helpful to reduce the difficulty of group 7 lymph node dissection, reduce the risk of bleeding, and not increase the postoperative complications. It is a simple and feasible method.