[1]韩志伟,胡文滕,马敏杰,等.高血压对达芬奇机器人经剑突纵隔肿瘤切除术后并发症的影响[J].新乡医学院学报,2023,40(5):437-442.[doi:10.7683/xxyxyxb.2023.05.007]
 HAN Zhiwei,HU Wenteng,MA Minjie,et al.Effect of hypertension on the complications after transxiphoid mediastinal tumor resection by Da Vinci robot[J].Journal of Xinxiang Medical University,2023,40(5):437-442.[doi:10.7683/xxyxyxb.2023.05.007]
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高血压对达芬奇机器人经剑突纵隔肿瘤切除术后并发症的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
40卷
期数:
2023年5
页码:
437-442
栏目:
临床研究
出版日期:
2023-05-05

文章信息/Info

Title:
Effect of hypertension on the complications after transxiphoid mediastinal tumor resection by Da Vinci robot
作者:
韩志伟1234胡文滕1234马敏杰1234蔺瑞江1234梁秋豪1234袁博文1234韩彪234
(1.兰州大学第一临床医学院,甘肃 兰州 730000;2.兰州大学第一医院胸外科,甘肃 兰州 730000;3.胸外科关键技术研发与应用专业甘肃省国际科技合作基地,甘肃 兰州 730000;4.甘肃省胸外科医疗质量控制中心,甘肃 兰州 730000)
Author(s):
HAN Zhiwei1234HU Wenteng1234MA Minjie1234LIN Ruijiang1234LIANG Qiuhao1234YUAN Bowen1234HAN Biao234
(1.The First Clinical Medical College,Lanzhou University,Lanzhou 730000,Gansu Province,China;2.Department of Thoracic Surgery,the First Hospital of Lanzhou University,Lanzhou 730000,Gansu Province,China;3.Major in R & D and Application of Key Technologies in Thoracic Surgery Gansu International Science and Technology Cooperation Base,Lanzhou 730000,Gansu Province,China;4.Gansu Provincial Medical Quality Control Center of Thoracic,Lanzhou 730000,Gansu Province,China)
关键词:
高血压达芬奇机器人经剑突纵隔肿瘤切除术术后并发症
Keywords:
hypertensionDa Vinci robottransxiphoid mediastinal tumor resectionpostoperative complication
分类号:
R655.5
DOI:
10.7683/xxyxyxb.2023.05.007
文献标志码:
A
摘要:
目的 探讨高血压对达芬奇机器人经剑突纵隔肿瘤切除术后并发症的影响。
方法 选择2019年1月至2022年3月兰州大学第一医院胸外科收治的行达芬奇机器人经剑突纵隔肿瘤切除术的77例患者为研究对象。根据术前是否有高血压将患者分为高血压组(n=21)与无高血压组(n=56),并依据高血压分级标准将高血压组患者分为高血压1级组(n=7)、高血压2级组(n=8)和高血压3级组(n=6)。比较高血压组与无高血压组及不同高血压分级组患者的年龄、性别、身高、体质量、体质量指数(BMI)、吸烟史、饮酒史、肿瘤最大径、病理类型等一般临床资料,以及术前麻醉时间、手术时间、术中出血量、术后视觉模拟疼痛评分(VAS)、术后使用镇痛泵时间、术后下床活动时间、胸腔引流量、胸管拔除时间、术后住院时间、住院费用等手术相关指标和术后并发症发生率。
结果 无高血压组与高血压组患者的年龄、性别、身高、BMI、吸烟史、饮酒史、肿瘤最大径、病理类型、术前麻醉时间、手术时间、术中出血量、术后VAS评分、术后镇痛泵使用时间比较差异无统计学意义(P>0.05);高血压组患者的术后下床活动时间显著晚于无高血压组,术后住院时间、胸管拔除时间显著长于无高血压组,胸腔引流量、住院费用显著多于无高血压组(P<0.05)。高血压组患者术后心包积液、心律失常、肺部感染、胸腔积液发生率显著高于无高血压组(P<0.05);2组患者术后重症肌无力、声音嘶哑、切口感染发生率比较差异无统计学意义(P>0.05)。高血压1级组、高血压2级组和高血压3级组患者的一般临床资料、手术资料和术后并发症比较差异均无统计学意义(P>0.05)。
结论 高血压可增加行达芬奇机器人经剑突纵隔肿瘤切除术患者术后心包积液、心律失常、肺部感染及胸腔积液的发生率,减缓患者术后康复,增加患者经济、疼痛负担,延长住院时间;高血压的严重程度对术后相关并发症的发生、术后康复、患者的经济及疼痛负担和住院时间并无显著影响。
Abstract:
Objective To investigate the effect of hypertension on the complications after transxiphoid mediastinal tumor resection by Da Vinci robot.
Methods A total of 77 patients who underwent transxiphoid mediastinal tumors resection by Da Vinci robotic in the Department of Thoracic Surgery,Lanzhou University First Hospital from January 2019 to March 2022 were selected as the study subjects.The patients were divided into hypertension group (n=21) and non-hypertension group (n=56) based on whether they had hypertension before surgery,and patients in the hypertension group were divided into hypertension grade 1 group(n=7),hypertension grade 2 group(n=8),and hypertension grade 3 group(n=6) according to the hypertension grading criteria.The general clinical data such as age,gender,height,body mass,body mass index (BMI),smoking history,alcohol consumption history,tumor maximum diameter,pathological type,and surgical related indicators including the preoperative anesthesia time,surgical time,intraoperative bleeding volume,postoperative visual analog pain score (VAS),postoperative use of analgesic pump,time to get out of bed,thoracic drainage flow,thoracic tube extraction time,postoperative hospitalization time,hospitalization costs,and the rate of postoperative complication of patients between the hypertension group and non-hypertension group and among the different grade of hypertension groups were compared.
Results There were no significant differences in age,gender,height,BMI,smoking history,alcohol consumption history,tumor maximum diameter and pathological type,preoperative anesthesia time,surgical time,intraoperative bleeding volume,postoperative VAS score and postoperative analgesia pump use time between the non-hypertensive group and the hypertension group (P>0.05);the time to get out of bed of the patients in the hypertension group was significantly later than that in the non-hypertension group,postoperative hospitalization time and thoracic tube extraction time were significantly longer than those in the non-hypertension group,and the thoracic drainage flow and hospitalization costs were more than those in the non-hypertension group (P<0.05).The incidences of postoperative pericardial effusion,arrhythmia,pulmonary infection and pleural effusion of patients in the hypertension group were significantly higher than those in the non-hypertension group (P<0.05);there was no significant difference in the incidence of postoperative myasthenia gravis,hoarseness and incision infection of patients between the two groups (P>0.05).There were no significant differences in general clinical data,surgical related indicators and postoperative complications of the patients among the hypertension grade 1 group,hypertension grade 2 group,and hypertension grade 3 group (P>0.05).
Conclusion Hypertension can increase the incidence of postoperative pericardial effusion,arrhythmia,lung infection and pleural effusion complications in patients undergoing Da Vinci robotic transxiphoid mediastinal tumor resection,retard the postoperative recovery of patients,increase the patient′s economy and pain burden,and prolong the length of hospital stay;the severity of hypertension has no significant effect on the occurrence of postoperative related complications,postoperative rehabilitation,economy and pain burden,and postoperative hospitalization time.

参考文献/References:

[1] El-AKKAWI A I,ECKARDT J.Comparison of surgical outcomes after robotic assisted thoracic surgery,video-assisted thoracic surgery and open resection of thymoma[J].Mediastinum,2021,5:11.
[2] SODER S A,POLLOCK C,FERRARO P,et al.Post-operative outcomes associated with open versus robotic thymectomy:a propensity matched analysis[J].Semin Thorac Cardiovasc Surg,2021,36(7):1-7.
[3] CHEN-YOSHIKAWA T F,FUKUT T,NAKAMURA S,et al.Current trends in thoracic surgery[J].Nagoya J Med Sci,2020,82(2):161-174.
[4] SHIDEI H,MAEDA H,ISAKA T,et al.Mediastinal paraganglioma successfully resected by robot-assisted thoracoscopic surgery with en bloc chest wall resection:a case report[J].BMC Surg,2020,20(1):45.
[5] SHINDO Y,MIYAJIMA M,MAKI R,et al.Successful robotic resection of left upper mediastinal tumor[J].Kyobu Geka,2020,73(9):663-666.
[6] HESS N R,BAKER N,LEVY R M,et al.Robotic assisted minimally invasive thymectomy with simultaneous bilateral thoracoscopy and contralateral phrenic nerve visualization[J].J Thorac Dis,2020,12(2):114-122.
[7] SICOLO E,CECCARELLI I,ROMANO G,et al.Robotic thymectomy:a surgical point of view[J].Multimed Man Cardiothorac Surg,2021,20(10):1-6.
[8] MARCHIORI E,HOCHHEGGER B,ZANETTI G.Pericardial effusion[J].J Bras Pneumol,2021,47(1):e20200587.
[9] 《中国高血压防治指南》修订委员会.中国高血压防治指南2018年修订版[J].心脑血管病防治,2019,19(1):1-44.
REVISION COMMITTEE OF THE "GUIDELINES FOR THE PREVENTION AND TREATMENT OF HYPERTENSION IN CHINA".Chinese guidelines for the prevention and treatment of hypertension (2018 revised edition)[J].Prevent Treat Cardio-Cereb-Vasc Dis,2019,19(1):1-44.
[10] 曾理平,王志田,何哲浩,等.达芬奇机器人与胸腔镜下纵隔肿瘤切除术的回顾性队列研究[J].中国胸心血管外科临床杂志,2020,27(3):279-283.
ZENG L P,WANG Z T,HE Z H,et al.Da Vinci robot-assisted surgery versus video-assisted thoracoscopic surgery for resection of mediastinal tumors:a retrospective cohort study[J].Chin J Clin Thoracic Cardiovasc Surg,2020,27(3):279-283.
[11] 刘通,王贺双,许凝.达芬奇机器人手术系统在胸腺瘤手术中的应用研究进展[J].大连医科大学学报,2019,41(4):357-360.
LIU T,WANG H S,XU N.Research progress of Da Vinci robotic surgical system in thymoma surgery[J].J Dalian Med Univ,2019,41(4):357-360.
[12] SATOH Y,HAYASHI S,NAITO M,et al.Introduction of minimally invasive thoracoscopic surgery for the anterior mediastinum;subxiphoid video-assisted thoracoscopic thymectomy and robot-assisted thymectomy[J].Kyobu Geka,2020,73(4):274-279.
[13] ADLI AZAM M R,SHAHRIL K,ANEEZ AHMED D B.Case report:robotic thoracic surgery of posterior mediastinal mass[J].Med J Malaysia,2020,75(4):428-429.
[14] AZENHA L F,DECKARM R,MINERVINI F,et al.Robotic vs.transsternal thymectomy:a single center experience over 10 years[J].J Clin Med,2021,10(21):1-8.
[15] MITSUBOSHI S,MAEDA H,KANZAKI M.Application of pelvic-style docking in robotic surgery for lower-middle mediastinal tumors[J].Asian Cardiovasc Thorac Ann,2021,29(5):440-442.
[16] QIN J,JING T,WANG P,et al.Retroperitoneal robot-assisted resection of a lower posterior mediastinal benign schwannoma using a transdiaphragmatic approach:a case report[J].Medicine (Baltimore),2020,99(38):e21765.
[17] 林丽云,李昂,沙丽,等.原发性高血压病人心、脑、肾靶器官损害的影响因素分析[J].中西医结合心脑血管病杂志,2021,19(21):3715-3719.
LIN L Y,LI A,SHA L,et al.Analysis of influencing factors of heart,brain and kidney target organ damage in patients with essential hypertension[J].Chin J Integr Med Cardio/Cerebrovasc Dis,2021,19(21):3715-3719.
[18] 骆雷鸣,任金霞.高血压心脏形态、结构改变及危害[J].中华保健医学杂志,2021,23(6):555-560.
LUO L M,REN J X.Morphology,structural changes and harm of hypertensive heart[J].Chin J Health Care Med,2021,23(6):555-560.
[19] 宋俊贤,李晓,李忠佑,等.以心包积液为主多浆膜腔积液患者的病因学分布和临床特征分析[J].中国循环杂志,2021,36(3):305-309.
SONG J X,LI X,LI Z Y,et al.Etiologies and clinical characteristics of polyserositis patients with pericardium involvement[J].Chin Circ J,2021,36(3):305-309.
[20] 余鹏,曾文飞,林凯玲,等.大量心包积液病因影响因素的回顾性分析[J].中国心血管病研究,2020,18(12):1082-1087.
YU P,ZENG W F,LIN K L,et al.Retrospective analysis of the etiological factors with large pericardial effusion[J].Chin J Cardiovasc Res,2020,18(12):1082-1087.
[21] FENDER E A,ZACK C J.Shining a new light on pericardial fluid[J].Heart,2021,107(19):1528-1529.
[22] JACKSON A H.Diagnosis and treatment of pericardial effusions[J].Radiol Technol,2021,92(3):259-278.
[23] RASQUINHA M,DEMBREY N,BHANGWANSINGH-HAYNE S,et al.A large pericardial effusion without haemodynamic compromise[J].Br J Hosp Med (Lond),2021,82(12):1-2.
[24] 吴军,许迪.非心脏外科手术围术期高血压的评估与处理[J].临床内科杂志,2022,39(1):8-10.
WU J,XU D.Evaluation and management of perioperative hypertension in noncardiac surgery[J].J Clin Int Med,2022,39(1):8-10.
[25] 吕玲春,沈珈谊,韦铁民.高血压与微循环障碍相关性的研究进展[J].温州医科大学学报,2021,51(11):933-937.
LYU L C,SHENG J Y,WEI T M.Research progress on the association between hypertension and microcirculatory disorders[J].J Wenzhou Med Univ,2021,51(11):933-937.
[26] 彭枫源,林万里,张海,等.快速康复外科模式应用于食管癌患者的效果分析[J].数理医药学杂志,2020,33(7):1073-1075.
PENG F Y,LIN W L,ZHANG H,et al.Effect analysis of rapid rehabilitation surgery model in patients with esophageal cancer[J].J Mathem Med,2020,33(7):1073-1075.
[27] LAZAROS G,VLACHOPOULOS C,LAZAROU E,et al.Contemporary management of pericardial effusion[J].Panminerva Med,2021,63(3):288-300.

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更新日期/Last Update: 2023-05-05