内镜辅助微创甲状腺手术和传统手术的临床效果比较  

Comparison of the therapeutic effect between nasal endoscopic incision and traditional thyroidectomy

作　　者：董秀志 黄新妍[2] 晁杰伟[2] 王永田[2] 蒋桃根[2] 

机构地区：[1]浙江省平湖市第一人民医院外科 [2]上海市杨浦区市东医院耳鼻咽喉科,上海200438

出　　处：《中国眼耳鼻喉科杂志》2011年第5期312-314,共3页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的探讨鼻内镜辅助下颈前小切口甲状腺手术的疗效、临床经验和手术注意事项,并与传统手术进行比较。方法我科术前确诊的单发甲状腺腺瘤患者26例,肿瘤最大直径﹤4.0 cm,均行鼻内镜辅助颈前小切口腺叶切除术,观察疗效,并与同期具有可比性的30例经传统手术治疗的患者资料进行比较。结果2组患者的肿块均完整切除,切口均I期愈合。术后无声音嘶哑、呛咳、继发血肿等并发症。无手术死亡病例。鼻内镜辅助下颈前小切口组的手术时间较对照组长(t=9.139,P<0.05),术中出血量较对照组大(t=12.648,P<0.05)。小切口组患者的瘢痕长度、患者满意度、住院天数明显优于对照组,差异有统计学意义(P<0.05)。结论鼻内镜辅助下颈前小切口甲状腺手术安全、可靠,能有效避免神经、血管损伤,具有并发症少、微创、美容的优点,值得临床推广。Objective To explore the clinical value, cosmetic advantage and safety of the nasal endoscopic anterior cervical incision thyroidectomy and to compare with the traditional incision thyroidectomy. Methods Data of 26 cases applied with nasal endoscopic anterior cervical incision thyroidectomy and 30 cases with traditonal incision thyroidectomy were analyzed. Results Operations were performed successfully in all patients, and there was no bleeding, hoarseness or other complications. Compared with the traditonal incision group,nasal endoscopic anterior cervical incision group had the longer operation time （ t = 9. 139, P 〈 O. 05 ） and more blood loss （ t = 12.648, P 〈 0.05 ）, but higher-satisfaction with cosmetic incision with shorter scars and earlier discharge（P 〈 0.05 ）. Conclusions Nasal endoscopic anterior cervical incision thyroidectomy demonstrated excellent results in patient cure rate and comfort ,with shorter hospital time, reduced postoperative pain, minimally invasive and most attractive cosmetic results.

关 键 词：鼻内镜 小切口 甲状腺腺瘤 

分 类 号：R736.1[医药卫生—肿瘤]