腔镜甲状腺手术与开放手术临床对比研究

目的比较腔镜手术和开放手术治疗甲状腺良性疾病的临床效果。方法回顾性分析2009年1月～2010年3月32例行腔镜甲状腺切除术和35例行开放甲状腺切除术患者的临床资料,比较两组手术时间、出血量、术后恢复活动时间、术后并发症、住院费用、患者对手术满意度等。结果腔镜组32例中除1例中转开放手术外,其余31例均获成功。两组手术时间比较无统计学差异(P>0.05);与开放组比较,腔镜组出血少,术后恢复时间短,费用高,患者对手术满意度高(P<0.05)。腔镜组术后有2例患者出现声音嘶哑等神经损伤症状,其中1例为桥本氏甲状腺炎患者,在术后4个月恢复,另1例为结节性甲状腺肿患者,术后1个月恢复正常。1例患者出现皮肤瘀斑,2周后恢复正常。开放组有2例并发症,其中喉返神经损伤1例,术后2个月自行恢复正常,甲状腺功能减退1例,口服甲状腺素片治疗。两组并发症率比较无统计学差异(P>0.05)。结论腔镜甲状腺手术具有美容效果好、出血少、术后恢复快的优点,在治疗甲状腺良性疾病方面,是具有良好发展前景的手术方式。

Effect Comparison between Endoscopic Thyroidectomy and Conventional Open Thyroidectomy

Objective To compare the clinical effect of endoscopic thyroidectomy with conventional open thyroidectomy. Methods From January 2009 to March 2010, thirty-two patients were underwent endoscopic thyroidectomy as endoscopic group, and thirty-five patients were underwent conventional open thyroidectomy as open group. The operation time, blood loss, recovery time of motion, postoperative complications, total cost and the proportion of patient satisfaction was compared between two groups in a retrospective study. Results Thir- ty-two cases were accomplished the endoscopic surgery successfully and one case was converse to open surgery in endoscopic group. There were no significantly difference in operation time between two groups（P 〉 0.05 ）. Com- pare to open group, the blood loss was less, postoperative recovery time of motion was shorter, the total cost was higher and proportion of patient satisfaction was higher in endoscopic group（P 〈0.05）. Hoarseness was found in two cases and ecchymosis in one case in endoscopic group, recurrent laryngeal nerve injury was in one case and hypothyroidism in one case in open group, but there was no statistic difference in postoperative complication rate between two groups （P 〉 0. 05）. Conclusion Endoscopic thyroidectomy has a favourable development future for benign thyroid diseases with the advantages as excellent cosmetic benefits, less blood loss and faster recovery.