腔镜甲状腺手术与传统手术创伤的比较研究

目的:比较腔镜甲状腺手术与传统手术对机体损伤的程度。方法:随机将甲状腺疾病患者42例分成两组,腔镜组21例,传统手术组21例。对两组的术中出血量、术后疼痛、血浆炎性因子水平的变化趋势、住院时间、术后3个月颈部感觉情况、吞咽情况等进行比较。结果:腔镜组术中出血(21±14)ml,明显少于传统手术组的(36±18)ml。术后第1天IL-2、IL-6、TNF和术后第2天IL-2水平腔镜组高于传统手术组,差异有统计学意义。术后48、72h腔镜组疼痛比传统手术组轻。术后3个月腔镜组未发生颈部感觉减退,1例吞咽不适,9例有胸骨前紧张感;传统手术组有11例颈部感觉减退或异常,9例吞咽不适,无胸骨前紧张感。腔镜组所有患者对术后美容效果均满意,传统手术组12例对术后美容效果不满意。结论:腔镜甲状腺切除术术中出血少、血浆炎性因子水平较传统手术高,但术后1周内与传统手术组均恢复正常,手术创伤对机体长期影响与传统手术互有优势。

Comparison of operative wound between endoscopic thyroidectomy and traditional thyroidectomy

Objective:To compare the organism affections between the endoscopic thyroidectomy and traditional thyroidectomy.Methods:From Dec.2003 to Dec.2006,forty-two patients were divided into two groups randomly,the endoscopic group(EG) and traditional group(TG).Each group has twenty-one patients.Bleeding during operation,pain and feelings after operation,the changes of the levels of plasma inflammation factors,hospitalization time,the cervical feelings three months after operation and swallowing function were compared.Results:Bleeding of EG were fewer than that of TG.The levels of IL-2,IL-6 and TNF of EG were lower than those of RG in the second day after operation.In EG,one patient felt discomfort and nine patients felt tight in anterior sternum at three months after operation.In TG,eleven patients got insensibility feeling and nine patients swallowed hard.Twelve patients were unsatisfied with the wounds of TG but there were none in EG.Conclusions:The difference of affections to organism between the two groups are not significant,and each group has its own advantages.