经乳晕腔镜手术与开放手术治疗良性甲状腺肿瘤的临床对比分析  

Comparison between Conventional Open Thyroidectomy and Endoscopic Thyroidectomy for Benign Thyroid Tumor

作　　者：吴立胜[1] 汪宏[1] 涂从银[1] 

机构地区：[1]安徽医科大学第三附属医院,合肥市第一人民医院普外Ⅱ科,合肥市230061

出　　处：《中国肿瘤临床》2008年第23期1321-1324,共4页Chinese Journal of Clinical Oncology

基　　金：安徽省卫生厅科研基金资助(编号:06B067)

摘　　要：目的:对经乳晕径路腔镜手术和开放甲状腺手术治疗甲状腺良性肿瘤的临床效果进行比较研究。方法:回顾性分析2002年8月～2008年5月102例经乳晕径路的腔镜下甲状腺切除术(腔镜组)和105例开放甲状腺切除术(开放组)患者的临床资料,比较两组的手术时间、住院费用、出血量、疼痛评分、住院时间、术后镇痛药的需求、引流量、术后并发症等。结果:两组手术中出血量无显著性差异(P=0.531);腔镜组手术时间为(124.59±42.48)分钟,开放组为(92.02±32.20)分钟,腔镜组明显长于开放组(P<0.05);住院时间和住院费用比较,腔镜组分别为(10.18±4.44)天、(6416.51±976.34)元,而开放组分别为(8.80±3.34)天和(4118.07±1354.66)元,腔镜组引流量(90.2±78.4)ml,开放组(50.2±20.5)ml,统计学比较均为P<0.05,腔镜组多于开放组;腔镜组术后并发症喉返神经损伤和开放组比较虽论无:统腔计镜学下差甲异状,腺但手损术伤是几一率种大安,发全生、可率行为的2.方94法%(,3具/1有02美);容而和腔疼镜痛组轻术的后优疼点痛;感但和进镇一痛步药拓需宽求应比用开需放要组重明视显和减克少服。喉返结神经损伤几率高、住院费用高、住院时间长、术后引流量大等缺点。Objective： To compare the clinical effects of endoscopic thyroidectomy using an approach through the breast and conventional open thyroidectomy for benign thyroid diseases. Methods： A total of 207 cases of benign thyroid diseases were surgically treated from August 2002 to May 2008, including 102 cases that underwent endoscopic thyroidectomy （endoscopic group） and 105 cases that underwent traditional thyroidectomy （traditional group）. The surgery duration, hospitalization cost, blood loss, Visual Analogue Scale （VAS） scores for pain severity, hospital stay, postoperative requirements for analgesics, volume of drainage, and postoperative complications were compared between the two groups. Results： No significant difference was found in in- traoperative blood loss between the two groups. Compared with the traditional group, the endoscopic group had longer surgery duration （P=-0.001）, longer hospital stay （P=0.170）, higher hospitalization cost （P=-0.000） and larger volume of drainage （P=-0.000）. There were fewer cases who needed analgesics after surgery in the endoscopic group than in the traditional group （16 cases vs. 52 cases, P=0.000）. No significant difference was found in the incidence of recurrent laryngeal nerve paralysis between the two groups. Conclusion： Compared with conventional surgery, endoscopic thyroidectomy is a feasible, practical and safe procedure for benign thyroid diseases, with excellent cosmetic benefits and less pain. Further studies are warranted to overcome the shortcomings of endoscopic thyroidectomy including higher hospitalization cost, longer hospital stay, and larger volume of drainage after surgery.

关 键 词：腔镜 甲状腺切除术 甲状腺良性肿瘤 开放手术 

分 类 号：R736.1[医药卫生—肿瘤] R692.4[医药卫生—临床医学]