甲状腺腺瘤不同术式切除的临床分析

目的 比较胸乳入路腔镜手术与传统开放手术在单侧甲状腺部分切除的f临床效果.方法 70例单侧甲状腺良性疾病分别行胸乳入路腔镜手术(腔镜手术35例)和开放手术(开放手术35例),比较两种术式的I临床治疗效果.结果 腔镜手术组手术时间(100.4±26.6)min,显著长于开放手术组(73.5±14.5)min(t=5.627,P=0.000);腔镜手术后引流量(66.7±24.9)ml,显著多于开放手术组(13.3±6.4)ml(t=14.403,P=0.000);腔镜手术组术后住院时间(4.3±1.1)d,显著长于开放手术组(3.6±0.9)d(t=2.886,P=0.005);腔镜手术组对手术美容效果表示满意22例,明显高于开放手术组(x2=7.235,P=0.007);腔镜手术组术中出血量(22.5±15.3)ml与开放手术组(18.3±7.5)ml差异无统计学意义(t=1.273,P=0.207).两组均无术后大出血、喉上神经损伤、甲状旁腺损伤等严重并发症.结论 胸乳入路腔镜单侧甲状腺部分切除术与传统开放手术均是安全、有效的手术方法,腔镜手术有更加令人满意的美容效果.

Comparison study results by two thyroidectomy

Objective To compare the clinical efficacy between endoscopic thyroidectomy via breast approach conventional open thyroidectomy in patients with nodular goiter. Methods A series of 70 patients with unilateral nodular goiter divided into two groups, either receiving endoscopic thyroidectomy through breast approach(endoscopic group,35 cases),or conventional open thyroidectomy(open group,35 cases). The therapeutic efficacy was compared between the two groups. Results The operating time of endoscopic group was significantly longer in the endoscopic group (100.4±26.6)min than in the open group (73.5±14.5) min(t=5. 627, P=0. 000). The postoperative drainage volume in the endoscopic group (66.7±24.9) ml significantly more than that in the open group ( 13.3±6.4)ml( t = 14. 403, P = 0. 000 ). The postoperative hospital stasignificantly longer in the endoscopic group (4.3±1.1 )d than in the open group (3.6±0.9)d(t=2.886, P=0.005). And a satisfactory cosmetic result was achieved in significantly more patients in the endoscopic group(9/24 cases) than in the open group(34/51 )(x2 = 7.235, P=0.007). There was no significant difference in intraoperative loss between the endoscopic group (22.5±15.3)ml and the open group (18.3±7.5 )ml(t=1.273, P=0.207), a consumption of analgesics between the endoscopic group (9/24 eases) and the open group(21/51 cases) (X2=0.028, P=0.867), respectively. No severe complications was encountered ,such as massive hemorrhage,injuries of the recurrent or sularyngeal nerve, or parathyroidgland injury. Conclusion Both breast approach endoscopic thyroidectomy and conventional open thyroidectomy are safe and effective, former gives better cosmetic outcomes.