甲状腺良性肿瘤腔镜手术与传统手术的临床疗效分析

目的 比较采用腔镜辅助下甲状腺手术与传统开放甲状腺手术的临床疗效.方法 2010年2月～2012年11月进入佛山市顺德区桂洲医院普外科行甲状腺腔镜手术的患者共148例,选择同期具有可比性且行传统甲状腺手术的病例153例作为对照组,对比分析两组患者的手术时间、手术切口长度、术中出血量、术后疼痛持续时间、术后引流量、术后住院时间、并发症发生率和满意率.结果 两组患者一般资料差异无统计学意义(P＞0.05).腔镜组较之开放组,手术时间(min)、切口长度(cm)、术中出血(mL)分别为(81.94±45.25)vs.(60.98±13.72)(P=0.043)]、(1.95±0.53)vs.(6.58±1.43) (P=0.000)]、(12.23±5.49) vs.(10.15±6.82) (P=0.238)]；术后引流量(mL)、疼痛持续时间(h)、术后住院时间(d)分别为(40.03±28.20) vs.(19.18±10.62) (P=0.048)]、(26.34±12.71)vs.(26.68±12.43)(P=0.178)]、(3±0.5)vs.(6±1.5)(P=0.038)]；并发症发生率与满意率分别为4.5％vs.6.7％(P=0.121)]、99.91％ vs.95.23％(P=0.010)].结论 腔镜手术与传统手术相比,在切口长度、术后住院时间和病患满意率方面显示出优势,术中出血量无明显增加,疼痛时间无明显延长,并发症无明显增加.然而,腔镜组较之开放组,手术时间明显延长、术后引流量有所增加.腔镜甲状腺手术将有待进一步改良技术和进一步开展临床应用.

Comparative study of the clinical effect of endoscopic thyroidectomy and traditional open thyroidectomy of thyroid benign tumor

Objective To compare the clinical effect of endoscopic thyroidectomy and traditional open thyroidectomy of thyroid benign tumor. Methods Selected 148 cases of endoscopic thyroidectomy patients between Feb 2010 and Nov 2011 in Guizhou Hospital of Shunde, and 153 cases selected traditional open surgery at the same period of operation time. Compared and analyzed the operation time, incision length, bleeding volume in operation, the postoperative drainage volume, postoperative pain time, days of postoperative hospitalization, complication rates and the satisfaction rates of two groups. Results Statistic analysis showed no significant difference between two groups in the general in- formation （P 〉 0.05）. Compare endoscopy group to traditional group, the operation time（min）, incision length（cm） and bleeding volume in operation（mL） were （81.94±45.25） vs. （60.98±13.72）（P = 0.043）, （1.95±0.53） vs. （6.58_±1.43）（P = 0.000）, （12.23±5.49） vs. （10.15±6.82）（P = 0.238） respectively; the postoperative drainage volume（mL）, the postop- erative pain time （h） and the days of postoperative hospitalization（d） were （40.03±28.20） vs. （19.18±10.62） （P = 0.048）, （26.34±12.71） vs. （26.68±12.43） （P = 0.178）, （3±0.5） vs. （6_1.5） （P = 0.038） respectively; the complication rates and the satisfaction rates were 4.5% vs. 6.7%（P = 0.121）,99.91% vs. 95.23% （P = 0.010） respectively. Con- clusion Compared with traditional open surgery, endoscopic technique in thyroid surgery has some advantages such as incision is small, the time of postoperative hospitalization is short and the satisfaction rates is high. The endoscopic technique is safe, reliable and effective without the bleeding volume in operation, the postoperative pain time and the complication rates increasing. But the operation time and the postoperative drainage volume are increasing in endo- scopic group.