经腋下入路与胸乳入路行腔镜下单侧甲状腺切除术的临床对比

目的探索经腋下入路与胸乳入路行腔镜下单侧甲状腺切除术的临床疗效。 方法回顾性分析2014年4月至2017年8月行腔镜下单侧甲状腺切除术148例患者的临床资料，根据入路方式的不同，分为腋下组(83例)与胸乳组(65例)。采用Stata 14.2统计软件包进行统计分析，术中术后资料计量资料采用( ±s)表示，比较采用独立t检验，并发症计数资料采用χ²检验，P<0.05为差异具有统计学意义。 结果腋下组患者手术时间低于胸乳组(P<0.05)，两组患者出血量、引流量、引流管留置时间与住院时间差异无统计学意义(P>0.05)。腋下组患者皮下积液低于胸乳组(P<0.05)，两组患者切口感染、甲状旁腺损伤、声音嘶哑的发生率差异无统计学意义(P>0.05)；腋下组患者术后满意度显著高于胸乳组患者(Z＝6.377，P＝0.000)。 结论经腋下入路腔镜下单侧切除甲状腺住院时间短、并发症少、患者满意度高，值得临床推广。

The comparative study of endoscopic unilateral thyroidectomy by the axillary approach and the chest-breast approach

ObjectiveTo explore the clinical outcome of endoscopic unilateral thyroidectomy by the axillary approach and the chest-breast approach. MethodsFrom April 2014 to August 2017, clinical data of 148 patients underwent unilateral thyroidectomy were retrospectively analyzed. The patients were divided into axillary group (83 cases) and chest-breast group (65 cases). Statistical analysis were performed by using Stata 14.2 software package. Measurement data such as intraoperative and postoperative indicators were expressed as mean±standard deviation and examined by using t-test. The complication rate were compared by using chi square test. A P value of <0.05 was considered as statistically significant difference. ResultsThe operation time of the axillary group was significantly lower than that of the breast group (P<0.05). There was no significant difference in terms of the amount of bleeding, flow rate, drainage tube retention time and hospitalization time between 2 group (P>0.05). The subcutaneous hydrops in the axillary group were significantly less than those in the chest-breast group (P<0.05). There was no significant difference of incidence of incisional infection, parathyroid injury and hoarseness between 2 groups(P>0.05). The degree of postoperative satisfaction in the axillary group was significantly higher than that in the chest-breast group (Z=6.377, P=0.000). ConclusionEndoscopic unilateral thyroidectomy by the axillary approach has advantages including shorter of hospitalization, fewer complications and higher satisfaction, which is worthy of clinical promotion.