腔镜下颈淋巴结扩清术治疗甲状腺癌的安全性及有效性研究

目的探讨腔镜下颈淋巴结扩清术治疗甲状腺癌的安全性、有效性及操作特点。方法98例甲状腺癌患者,依据手术方式不同分为对照组(48例)及观察组(50例)。对照组采取常规切口开放式手术治疗,观察组应用腔镜下颈淋巴结扩清术治疗。对比两组患者淋巴清扫数目、颈部瘢痕长度、术中出血量、患者满意度及术后并发症发生情况。结果两组患者淋巴结清扫数目比较差异无统计学意义(P>0.05);观察组颈部瘢痕长度(4.8±1.8)cm短于对照组的(10.5±3.2)cm,术中出血量(10.8±2.3)ml少于对照组的(25.4±5.6)ml,差异均有统计学意义(P<0.05)。观察组患者治疗满意度96.0%(48/50)显著高于对照组的83.3%(40/48),差异有统计学意义(P<0.05)。观察组患者术后并发症发生率4.0%(2/50)低于对照组的16.7%(8/48),差异有统计学意义(P<0.05)。结论对甲状腺癌患者采取腔镜下颈淋巴结扩清术治疗,具有安全、美容、患者满意度高等优势,但术中应严格把握清扫层次,保证手术效果。

Study on the safety and effectiveness of endoscopic neck lymph node dissection in thyroid carcinoma

Objective To discuss the safety,effectiveness and operating characteristics of endoscopic neck lymph node dissection in thyroid carcinoma.Methods A total of 98 patients with thyroid carcinoma were divided into control group(48 cases)and observation group(50 cases)according to different surgical methods.The control group was treated with routine conventional incision open surgery,and the observation group was treated with endoscopic neck lymph node dissection.The number of lymphatic dissections,neck scar length,intraoperative blood loss,patient satisfaction and occurrence of postoperative complications were compared between the two groups.Results There was no statistically significant difference in number of lymphatic dissections between the two groups(P>0.05).The neck scar length(4.8±1.8)cm of the observation group was shorter than(10.5±3.2)cm of the control group,and intraoperative blood loss(10.8±2.3)ml was less than(25.4±5.6)ml of the control group.All the difference was statistically significant(P<0.05).The patient satisfaction 96.0%(48/50)of the observation group was significantly higher than 83.3%(40/48)of the control group,and the difference was statistically significant(P<0.05).The incidence of postoperative complications 4.0%(2/50)of the observation group was lower than 16.7%(8/48)of the control group,and the difference was statistically significant(P<0.05).Conclusion Endoscopic neck lymph node dissection has the advantages of safety,beauty and high patient satisfaction,but the level of dissection should be strictly controlled to ensure the surgical effect.