腔镜与开放甲状腺大部切除术治疗甲状腺机能亢进症的对比研究  

Comparision of endoscopic thyroidectomy and conventional open thyroidectomy in the treatment of primary hyperthyroidism

作　　者：王汉宁[1] 向国安[1] 陈开运[1] 肖金丰[1] 李鹏胜[1] 余智涛[1] 

机构地区：[1]广东省第二人民医院普外科,吴阶平医学基金会-诺道夫微创外科培训中心,广州510317

出　　处：《中华内分泌外科杂志》2010年第2期87-89,共3页Chinese Journal of Endocrine Surgery

摘　　要：目的比较腔镜和开放两种甲状腺大部分切除术治疗甲状腺机能亢进症的临床价值。方法回顾性分析64例采用双乳晕、左腋三孔法腔镜甲状腺大部分切除术（ET组）和63例开放甲状腺大部分切除术（OT组）治疗原发性甲状腺机能亢进症的临床资料。结果两组年龄、性别、病程、术前甲状腺肿大程度、并发症及L、T4、TSH水平等方面差异无统计学意义（P〉0．05），具有可比性。所有手术均获成功，ET组无中转。两组住院时间比较，差异无统计学意义。ET组失血量（88．2±67．3）ml明显少于OT组（122．2±62．8）ml，而ET组手术时间（115．2±24。6）min长于OT组（93．4±38．1）min，引流量（144．04±38．72）ml多于OT组（84．86±76．11）ml，ET组住院总费用（10596．1±1526．3）元多于OT组（66359．9±5885．9）元，差异有统计学意义（P〈0．05）。ET组发生一过性声音嘶哑6例，OT组3例，无其他严重并发症。所有患者均获随访，平均48．6个月，ET组出现甲低3例和甲亢复发4例，OT组甲低4例和甲亢复发2例。结论选择合适的病例实施腔镜治疗原发性甲状腺功能亢进安全、可行，具有美容、疼痛轻、出血少的优点。Objective To compare endoscopic thyroidectomy（ET） with conventional open thyroideetomy （OT） for treatment of primary hyperthyroidism. Methods Total of 127 patients with primary hyperthyroidism had thyroidectomy in our hospital from January 2003 to May 2008. Among them, 64 patients underwent ET （group ET） and 63 had OT （group OT） and their clinical data were analyzed retrospectively. Results There was no significantly difference in age, sex, disease course, size of thyroid, complication and T3, T4 , TSH level （P〉0.05）. All operations were successfully carried out. Operation time was longer in group ET （115.2 ± 24. 6） min than that in group OT （93.4 ±38.1 ） min （ P 〈 0.5 ）. Blood loss in group ET was significantly less （ 88.2 ± 67.3 ） ml than group OT （ 122.2 ± 62.8 ） ml （ P 〈 0.5 ）, but the drainage volume in group ET（ 144.04 ± 38.72 ） ml was more than group OT（ 84.86 ± 76.11 ） ml （ P 〈 0.05 ）. The cost of hospitalization in group ET was higher than OT but there was no significantly difference in hospital stay between two groups. 6 cases in group ET and 3 cases in group OT had temporary hoarseness but no significant difference was found. No erious complica- tions in all cases. 3 hypothyroidism and 4 recurrent hyperthyroidism occurred in group ET while 4 hypothyroidism and 2 recurrent hyperthyroidism in group OT during a 48.6 month＇s follow-up. Conclusions If suitable case is selected, ET is a feasible and safe therapy for primal3, hyperthyroidism and has an advantage of good cosmetic re- sult, less pain and less blood loss.

关 键 词：腔镜 甲状腺功能亢进 甲状腺大部切除术 

分 类 号：R653[医药卫生—外科学]