改良Miccoli术治疗甲状腺占位性病变学习曲线探讨  

Learning curve in the usage of modified Miccoli operation on thyroid space occupying lesion

作　　者：许鸣超[1] 孟祥朝[2] 张自立[2] 庞毅[2] 鲍旭[2] 

机构地区：[1]天津医科大学第三中心临床学院,天津300170 [2]天津市第三中心医院

出　　处：《山东医药》2012年第46期44-46,共3页Shandong Medical Journal

摘　　要：目的探讨改良Miccoli术治疗甲状腺占位性病变的效果及学习曲线。方法回顾性分析97例采用改良Miccoli术式治疗的甲状腺占位性病变患者的临床资料,依据手术先后顺序分为A组(15例)、B组(15例)、C组(15例)、D组(15例)、E组(15例)、F组(22例)共六组。六组均采用改良Miccoli术式治疗,比较六组性别、年龄、肿瘤直径、手术时间、术中出血量、总住院时间、术后住院时间、并发症发生率。根据每例手术时间及各组平均手术时间绘制学习曲线图,并采用莱特学习曲线的数学模型设计学习曲线函数,计算达到手术时间稳定和最小手术并发症发生率所需的手术例数。结果 97例手术均顺利完成,C组、D组、E组和F组的手术时间、术后住院时间均短于A组、B组(P<0.05),六组性别、年龄、肿瘤直径、术中出血量、总住院时间、并发症发生率比较,P均>0.05。随访4～12个月,各组均无复发病例。学习曲线为28例。结论改良Miccoli术治疗甲状腺占位性病变效果好、创伤小、安全,且美容效果好。该术式的学习曲线约为28例。Objective To investigate the effect and learning curve of modified Miccoli operation on thyroid space occupying lesion.Methods A total of 97 patients diagnosed with thyroid space occupying lesion were divided into six groups according to the surgical scequencing,which was group A（15 cases）,group B（15 cases）,group C（15 cases）,group D（15 cases）,group E（15 cases）,group F（22 cases）.All patients in six groups were treated by modified Miccoli operation.Genders,ages,tumor diametors,operative time,blood loss,time of total hospitalization,time of postoperative hospitalization,rate of complications of the six groups were compared.Charts of the learning curve were drawn according to each patient′s operative time and each group′s mean operative time.Mathematical model of Wright′s learning curve was applied to design the learning curve function by which to calculate the number of cases that has stable operative time and minimum complications incidence.Results Each operation of 97 cases was successful.Time of operation in group C,D,E,F were shorter than that of group A and B（P〈0.05）.There was no statistical significance between the 6 groups in gender,age,tumor diametor,blood loss,time of total hospitalization and rate of complications（P〉0.05）.No patient recurred after the following 4 to 12 months.The number of cases calculated by mathematical model was 28.Conclusions Modified Miccoli is a better effects,fewer traumas and safe operation as well as has a better cosmetic results on treating thyroid tumors.The learning curve is approximately 28 cases.

关 键 词：改良Miccoli术 甲状腺切除术 甲状腺占位性病变 学习曲线 

分 类 号：R653[医药卫生—外科学]