腔镜治疗原发性甲亢的临床研究(附27例报告)  

The treatment of primary hyperthyroidism with endoscopy (A report of 27cases)

作　　者：杨喜光[1] 向国安[1] 王汉宁[1] 陈开运[1] 李鹏胜[1] 肖方联[1] 

机构地区：[1]广东医学院教学医院,广东省第二人民医院普通外科,广州510317

出　　处：《微创医学》2008年第5期440-442,共3页Journal of Minimally Invasive Medicine

摘　　要：目的探讨腔镜甲状腺手术治疗原发性甲状腺功能亢进的可行性及临床价值。方法采用乳晕、胸骨前三孔法(胸壁途径)对27例原发性甲状腺功能亢进患者施行腔镜下甲状腺大部切除术,并与同期63例原发性甲状腺功能亢进开放手术患者进行对比研究。结果腔镜组均成功地施行了腔镜双侧甲状腺大部切除术,无1例中转开放手术。腔镜组和开放组的手术时间分别为(107.6±8.5)min、(78.3±23.8)min,术中出血量分别为(40.4±9.6)mL、(60.6±17.5)mL,术后住院时间分别为(5.2±1.0)d、(6.6±1.4)d;P均<0.05。术后腔镜组发生一过性声音嘶哑2例,发生胸前皮下淤斑2例,暂时性甲状腺功能低下8例;开放组发生一过性声音嘶哑5例,暂时性甲状腺功能低下20例。两组的并发症均在术后短期内恢复。无其他严重并发症。结论和传统的开放甲状腺手术治疗原发性甲状腺功能亢进相比较,腔镜双侧甲状腺大部切除术治疗原发性甲亢安全、可行,具有颈部无瘢痕的良好美容效果。Objective To study the feasibility and clinical value of treating primary hyperthyroidism by subtotal thyroidectomy under endoscopy. Methods Endoscopic subtotal thyroidectomy via the areola of nipple and proso-sternum （ breast approach） was performed on 27 patients with primary hyperthyroidism from September 2003 to September 2007, and compare with the 63 primary hyperthyroidism patients with traditional operation. Results Endoscopic subtotal thyroldectomy was successfully carried out in 27 cases of endoscopic team,without any case was converted to traditional surgery. The information of endoscopic team compare with traditional team： the operative time：（ 107.6 ± 8.5）min vs （78.3 ± 23.8） min, the blood loss during the operation ： （40.4 ± 9.6） mL vs （ 60.6 ± 17.5 ） mL; and the post operative hospital stay was （ 5.2 ± 1. 0） days vs （6.6 ± 1.4） days （ P 〈 0.05） . After surgery,there were 2 cases of temporary hoarseness,2 cases of subcutaneouly ecchymosis and 8 cases of temporary hypothyroidism in endoscopic team,while 5 cases of temporary hoarseness and 20 cases of temporary hypothyroidism in traditional team. All these cases in the two teams were recovered in short-term. Conclusion Compared to traditional operation, endoscopic subtotal thyroidectomy is safe, feasible and practical, presenting a significant cosmetic advantage by leaving no scar around the neck.

关 键 词：甲状腺功能亢进 甲状腺大部切除术 腔镜 

分 类 号：R653[医药卫生—外科学]