经胸前径路内镜甲状腺切除术与常规入路的比较研究  

Endoscopic thyroidectomy by the breast approach:a comparative study with routine approach

作　　者：江道振[1] 仇明[1] 张军初[1] 徐昕昀[1] 丁尔迅[1] 林峰[1] 王伟军[1] 

机构地区：[1]第二军医大学长征医院普通外科,上海200003

出　　处：《中华普通外科杂志》2004年第8期486-487,共2页Chinese Journal of General Surgery

摘　　要：目的探讨经胸前径路内镜甲状腺切除术的优缺点。方法将 2 0 0 2年 8月至 2 0 0 3年4月间我院收治的 6 0例甲状腺单发肿块患者随机分 2组 ,分别行经胸前径路内镜甲状腺切除术和常规切口甲状腺切除术 ,比较 2组病例的手术时间、费用、术后疼痛、并发症及美容效果。结果内镜手术组的手术时间为 (118 0± 34 3)min ,常规手术组为 (80 0± 2 3 5 )min ,两组相比 ,差异有显著性 (t=5 0 0 5 ,P <0 .0 0 1) ;内镜手术组的费用为 (10 4 33 6± 1131 6 )元 ,常规手术组为 (6 338 4± 10 82 7)元 ,两组相比 ,差异有显著性 (t=14 32 2 ,P <0 0 0 1) ;内镜手术组术后疼痛比常规手术组轻 ,均不用镇痛剂 ,且内镜手术组患者术后颈部活动早 ;内镜手术组颈部不留瘢痕。常规手术组有 1例患者喉返神经损伤 ,而内镜手术组出现 2例暂时的喉返神经麻痹。结论经胸前径路内镜甲状腺切除术与常规甲状腺切除术一样安全 ,虽然手术时间长、费用高 ,但具有术后恢复快、美容效果好等优点。ObjectiveTo evaluate the advantages and disadvantages of endoscopic thyroidectomy by the breast approach. MethodsFrom August 2002 to April 2003, sixty single thyroid nodule patients were divided into 2 groups randomly. Group 1 (30 patients) received endoscopic thyroidectomy(ET) by the breast approach. The other 30 patients underwent conventional thyroidectomy(CT). Preoperative diagnosis,operative time,operative cost,postoperative pain,complications,and cosmetic result between the 2 groups were compared. ResultsOperative time was 118.0±34.3 minutes for ET group and 80.0±23.5 minutes for CT group( P <0.001). Operative cost was 10 433.6±1 131.6 yuan for ET and 6 338.4±1 082.7 yuan for CT group ( P <0.001). Postoperative course was significantly less painful in the patients undergoing ET. Cosmetic result was much better in ET group. One recurrent palsy developed in CT patients and two transient palsies in ET group. [WT5”HZ]ConclusionsHaving the disadvantages of longer operative time and higher cost,ET is of less postoperative pain,better cosmetic result and at the same time as safe as the conventional thyroidectomy.

关 键 词：经胸前径路 内镜 甲状腺切除术 手术入路 甲状腺腺瘤 

分 类 号：R653[医药卫生—外科学]