改良Miccoli术与开放手术治疗甲状腺良性疾病效果比较

目的 比较改良Miccoli术与传统开放手术治疗甲状腺良性疾病的临床效果.方法 回顾分析2013年1-10月在我院接受手术治疗的良性甲状腺疾病67例患者临床资料,将35例选择改良Miccoli甲状腺手术作为微创组,另32例为同期具有可比性的开放甲状腺手术作为对照组,对比两组患者手术时间、切口长度、术中出血量、术后引流量、术后住院时间、住院费用及并发症情况.结果 微创组手术时间（67.41±10.96） min,比对照组（47.78±11.31）min]延长,住院费用分别为（8 810.28±800.59）元和（6 766.44±1 037.85）元,差异均有统计学意义（t值分别为7.212、9.069,P均＜0.05）;而微创组切口长度（2.86±0.50） cm]、术中出血量（15.03±5.56） ml]、术后引流量（14.93±4.61）ml]、术后住院时间（3.41±1.21）d]均小于对照组（6.21±1.20） cm、（33.72±12.49） ml、（29.75±13.89） ml、（5.59±1.16）d],差异均有统计学意义（t值分别为-15.148、-8.030、-5.967、-7.513,P均＜0.05）.术后并发症两组比较差异无统计学意义（P =0.949）.结论 改良Miccoli术式与传统术式相比,具有微创、安全、美观、实用和操作相对简单的特点,除手术时间稍长,费用较高外,均有明显优势,患者满意度高,值得推广.

Comparison the clinical efficacy of modified Miccoli mode endoscopic thyroidectomy and open operation in the treatment of benign thyroid diseases

Objective To compare the clinical efficacy of modified Miccoli mode endoscopic thyroidectomy with the traditional open operation in the treatment of benign thyroid diseases.Methods Sixtyseven patients with benign thyroid diseases treated by surgery were selected as our subjects in General Surgery Department,Anhui Provincial Corps Hospital of Chinese People＇s Armed Police Forces from Jan.2013 to Oct.2013.Thirty-five cases in minimally invasive group were treated by modified Miccoli mode endoscopic thyroidectomy,while another 32 cases in control group with comparability in the same term were treated by open thyroidectomy.The operative time,incision size,periods operative,bleeding volume,post-operative drainage volume,post-operative hospital stay,hospital costs and complications were recorded.Results The operation periods and total fees during hospitalization in minimally invasive group were （67.41 ± 10.96） min,（8 810.28 ±800.59） yuan,higher than that in control group（（47.78 ± 11.31） min,（6 766.44 ± 1 037.85） yuan; t =7.212,9.069;P 〈 0.05）.The length of incision,bleed amount during operation,post-operative drainage volume,and hospitalization time in minimally invasive group were （2.86 ± 0.50） cm,（15.03 ± 5.56） ml,（14.93 ±4.61） ml,（3.41 ±1.21） d,less than those in control group（（6.21 ±1.20） cm,（33.72 ±12.49） ml,（29.75 ± 13.89） ml,（5.59 ± 1.16） d）,and the differences＇ were significant （t =-15.148,-8.030,-5.967,-7.513 respectively; P 〈 0.05）.The complications of two groups had no significant difference（P =0.949）.Conclusion The modified Miccoli mode endoscopic thyroidectomy compare with the traditional open operation have the characteristics of minimallyinvasive,safe,beautiful,practical and operational relatively simple,except longer operative time and higher hospital costs.There are obvious advantages and be worth of promoting.