甲状腺固定解除在腔镜下甲状腺功能亢进手术中的应用研究  

Clinical application research of thyroid attachment removal in endoscopic thyroidectomy for Graves' disease

作　　者：岑宏[1] 汤聪[1] 梁文丰[1] 殷放[1] 徐飞[1] 

机构地区：[1]中山大学附属第五医院普外4区微创外科中心,珠海519000

出　　处：《中华普通外科学文献（电子版）》2014年第1期27-30,共4页Chinese Archives of General Surgery(Electronic Edition)

摘　　要：目的探讨腔镜下手术治疗甲状腺功能亢进(甲亢)的实用性和安全性。方法回顾性分析2008年1月至2011年12月收治的115例甲亢患者资料,术前准备方法相同及采用甲状腺固定解除手术方式的45例患者入组,分为开放手术组(28例)和腔镜手术组(17例),对两组患者年龄、手术时间、术中出血量、术后引流量、术后并发症、住院天数、住院费用等数据进行统计学分析。结果开放组平均年龄(34.6±10.1)岁,腔镜组(27.1±5.7)岁,两组年龄差异有统计学意义(P<0.05)。两组术中出血量、住院天数、住院费用、服碘前甲状腺容积、术后低钙血症、喉返或喉上神经损伤等数据差异无统计学意义。开放组手术时间平均(1.68±0.69)h,术后引流量平均(95.0±68.3)ml;腔镜组手术时间平均(2.87±0.67)h,术后引流量平均(179.7±70.8)ml,两组数据差异均有统计学意义(P<0.05)。腔镜组无一例中转为开放手术,随访至今无甲状腺功能低下或甲亢复发者。结论腔镜下采用甲状腺固定解除手术方式治疗甲亢是安全、可行的。Objective To investigate the practicability and safety of endoscopic thyroidectomy for treatment of Graves＇ disease. Methods One hundred and fifteen patients with Graves＇ disease from January 2008 to December 2011 were retrospectively analyzed. Forty-five patients undergoing the same preoperative preparations and via attachment removal approach were included in this study and were divided into open surgery group （28 cases） and endoscopic surgery group （17 cases）. Statistical analysis had been conducted on data including age, operative time, amount of bleeding during the operation, postoperative suction drainage, hospital stay, postoperation complication, and hospitalization expense between the two groups. Results The mean age for open group and endoscopic group was （34.6±10.1） and （27.1±5.7） respectively;the difference had statistical significance. The differences of the mean amount of bleeding, mean hospital stay, hospitalization expense, thyroid volume before patients taking iodine, hypocalcemia and recurrent laryngeal nerve or superior laryngeal nerve injuries between the groups were not statistically significant. The mean operative time and postoperative suction drainage of open group was （1.68±0.69） h and （95.0±68.3） ml respectively;while that of endoscopic group was （2.87±0.67） h and （179.7±70.8） ml. There were statistical significances between the differences （P〈0.05）. No conversion was required in endoscopic group. No hypothyroidism or recurrent hyperthyroidism had occurred up to now. Conclusion Endoscopic thyroidectomy for Graves＇ disease via attachment remove approach is safe and feasible.

关 键 词：腔镜手术 甲状腺固定解除 甲亢 甲状腺容积 

分 类 号：R653[医药卫生—外科学]