经颈部入路微创腔镜手术治疗对甲状腺微小癌患者临床疗效及并发症发生的影响

目的探讨经颈部入路微创腔镜手术治疗甲状腺微小癌的效果及安全性。方法前瞻性选取2018年1月至2020年1月期间江汉大学附属湖北省第三人民医院收治的80例甲状腺微小癌患者,按随机数字表法分为对照组与研究组,各40例,分别给予常规术式治疗、经颈部入路微创腔镜手术治疗。比较2组患者手术进行时间、术中出血量、手术切口长度、术后引流、住院时间、治疗费用、术后疼痛情况、临床疗效及术后并发症发生情况。结果研究组切口长度、术后住院时间为(25.06±2.30) mm、(3.54±1.22) d,均短于对照组(69.60±4.30) mm、(5.86±3.21) d],术中出血量、住院治疗费用为(15.00±8.00) mL、(8 055.36±712.25)元,均少于对照组(29.50±16.12) mL、(9 564.52±898.33)元],研究组手术时间(90.00±10.00) min]高于对照组(77.51±15.00) min],差异均有统计学意义(P <0.05),术后引流量比较(37.05±14.60) mL vs.(35.07±10.00) mL]差异无统计学意义(P> 0.05)。研究组手术后6、12、24 h视觉模拟评分法(VAS)评分分别为(3.00±0.57)、(2.01±0.35)、(1.10±0.21)分,低于对照组(4.12±0.89)、(3.54±0.77)、(3.00±0.54)分],差异均有统计学意义(P <0.05)。研究组临床疗效(97.50%)高于对照组(85.00%),差异有统计学意义(P <0.05)。研究组手术后并发症发生率(32.50%)低于对照组(5.00%),差异有统计学意义(P <0.05)。结论与常规手术方式对比,经颈部入路微创腔镜手术治疗甲状腺微小癌具有术中出血量少,能缓解术后疼痛,手术疗效确切,术后并发症率低等优势,但是手术操作耗时较长,该术式在临床上具有较高应用价值。

Influence of minimally invasive endoscopic surgery via neck approach on the clinical efficacy and complications of patients with thyroid microcarcinoma

Objective To investigate the efficacy and safety of minimally invasive endoscopic surgery via cervical approach in the treatment of thyroid microcarcinoma.Methods From January 2018 to January 2020,80 patients with thyroid microcarcinoma admitted to the Third People's Hospital of Hubei Province Affiliated to Jianghan University were prospectively selected.According to the random number table method,they were divided into control group and study group,each group were 40 cases,they were given routine surgical treatment,the neck into the way of minimally invasive surgical treatment of cavity mirrors.The operation time,blood loss during operation,length of incision,postoperative drainage,length of hospital stay,cost of treatment,pain after the operation situation,clinical curative effect,complications after the operation were compared.Results The incision length and postoperative hospital stay in the study group were(25.06±2.30)mm and(3.54±1.22)d,which were shorter than those in the control group(69.60±4.30)mm,(5.86±3.21)d],intraoperative blood loss,the cost of inpatient treatment were(15.00±8.00)mL and(8055.36±712.25)yuan,which were less than those in the control group(29.50±16.12)mL,(9564.52±898.33)yuan],and the operation time of the study group was(90.00±10.00)min],which was higher than the control group(77.51±15.00)min],the differences were statistically significant(P<0.05),the postoperative drainage volume comparison was difference no statistical significance(37.05±14.60)mL vs.(35.07±10.00)mL](P>0.05).The visual analogue scoring(VAS)scores of the study group were(3.00±0.57),(2.01±0.35),and(1.10±0.21)points at 6,12,and 24 h after surgery,which were lower than those of the control group(4.12±0.89),(3.54±0.77),(3.00±0.54)points],the differences were statistically significant(P<0.05).The clinical efficacy of the study group(97.50%)was higher than that of the control group(85.00%),and the difference was statistically significant(P<0.05).The incidence of postoperative complications in the study group(32.50%)was lower than that in the control group(5.00%),and the difference was statistically significant(P<0.05).Conclusion Compared with conventional surgical methods,minimally invasive laparoscopic surgery through the neck approach for the treatment of thyroid microcarcinoma has the advantages of less intraoperative blood loss,ease of postoperative pain,definite surgical efficacy,and low postoperative complication rate,but the operation takes a long time.It has high clinical application value.