腔镜甲状腺切除术在原发性甲亢外科治疗中的应用研究

目的:探讨腔镜甲状腺切除术在原发性甲亢外科治疗中的临床应用效果。方法:回顾分析2011年9月至2014年9月手术治疗的95例原发性甲亢患者的临床资料,其中63例行腔镜手术(腔镜组),32例行开放手术(开放组),对比分析两组患者手术时间、出血量、术后引流量,术后引流时间、术后住院时间、美容满意度、并发症、复发率等指标。结果:腔镜组出血量、术后引流量、术后引流时间、术后住院时间、美容满意度均优于开放组(P0.05),而开放组手术时间优于腔镜组(P0.05);腔镜组术后颈部感觉异常少于开放组(P0.05),两组声嘶、抽搐、呛咳、吞咽不适、切口液化或感染、创面血肿或积液、甲亢危象等并发症发生率差异无统计学意义(P0.05)。两组术后复发率及甲减发生率差异亦无统计学意义(P0.05)。结论:腔镜手术治疗原发性甲亢安全、可行,与开放手术相比,具有美容效果好、出血少、康复快等优点。

Application research of endoscopic thyroidectomy in the treatment of primary hyperthyroidism

Objective:To research the clinical effect of endoscopic thyroidectomy in the treatment of primary hyperthyroidism . Methods:Ninety-five patients of primary hyperthyroidism in Tung Wah hospital from Sep .2011 to Sep.2014 were retrospectively ana-lyzed.Sixty-three patients underwent endoscopic thyroidectomy ,while thirty-two patients underwent open thyroidectomy .The operation time,intraoperative blood loss,postoperative drainage,time of drainage,postoperative hospital stay,cosmetic satisfaction,the incidence of complications ,recurrence rate and occurring rate of hypothyroidism were observed in two groups .Results:There was statistically signifi-cant difference in intraoperative blood loss ,postoperative drainage ,time of drainage ,postoperative hospital stay ,cosmetic satisfaction and neck sensory abnormality,endoscopic group was better than open group (P<0.05).Open group was better than endoscopic group in operation time (P<0.05).There were no statistically significant differences in hoarseness ,twitch,bucking,swallowing discomfort, wound infection,incision liquefaction,hematoma or effusion in surface of wound ,hyperthyroidism crisis,recurrence rate and occurring rate of hypothyroidism between two groups (P>0.05).Conclusions:Endoscopic thyroidectomy in the remedy of primary hyperthyroid-ism is feasible and safe .It has advantages of good cosmetic result ,little blood loss and quick recovery compared with conventional open thyroidectomy .