全腔镜与腔镜辅助小切口术式在甲状腺手术中的应用  

Comparison and application of complete endoscopic and endoscope assisted small incision in thyroid surgery

作　　者：陈旭辉[1] 关养时[1] 安文伟[1] 刘丹[1] 江燕飞[1] 方圆[1] 

机构地区：[1]深圳市罗湖区人民医院普外科,广东深圳518089

出　　处：《局解手术学杂志》2015年第5期542-545,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的研究对比全腔镜(CE)与腔镜辅助小切口术式(EASIO)在甲状腺手术中的应用。方法选择2010年9月至2013年9月我院收治的甲状腺患者279例作为研究对象,其中239例接受甲状腺手术,根据手术方式分为CE组(n=95)和EASIO组(n=144)。另40例接受甲状旁腺手术,根据手术方式分为CE组(n=5)和EASIO组(n=35)。对比CE及EASIO术式在甲状腺病症中的手术相关指标,CE及EASIO术式应用于甲状腺病症的术后结果,以及CE及EASIO术式应用于甲状旁腺的情况。结果关于甲状腺病症,CE组的女性比例、腺瘤或单侧腺叶切除者比例、甲状腺体积、结节最长径、腺瘤或腺叶切除时间、双叶次全切或全切时间及术中出血量均显著高于EASIO组,而年龄、双叶次全切或全切比例均显著低于EASIO组,差异有统计学意义(P<0.05)。CE组的前胸不适比例、VAS术后疼痛评分、住院时间及美容效果的满意评分均显著高于EASIO组,差异有统计学意义(P<0.05)。关于甲状旁腺病症,CE组的年龄显著低于EASIO组,但手术时间及住院时间均显著高于EASIO组,差异有统计学意义(P<0.05)。结论甲状腺手术中应用CE及EASIO术式治疗各有优劣势,应综合考虑患者病情及自身要求,制订最佳手术方案。Objective To study the advantages and disadvantages of the application of complete endoscopic and endoscope assisted small incision in thyroid surgery. Methods From September 2010 to September 2013,279 patients with thyroid diseases in our hospital were selected as the research object. Among them,239 cases of thyroid surgery were grouped according to the surgical method,the complete endoscopic group with 95 cases,endoscope assisted small incision surgery group with 144 cases. The other 40 cases of parathyroid surgery were grouped according to the surgical method,the complete endoscopic group with 5 cases,endoscope assisted small incision group with 35 cases.The results and indicators related to the surgery with the complete endoscopic and endoscope assisted small incision for the thyroid disease and parathyroid gland were compared. Results About thyroid disease,the proportion of women in the complete endoscopic group,the adenoma or unilateral gland leaf proportion,thyroid volume,the tumor nodules longest diameter,adenoma or glandular lobe resection time,double leaf full cut or full cutting time and intraoperative blood loss were significantly higher than that of endoscope assisted small incision group,and the age,double leaf time full cut or full cut rate were significantly lower than that of endoscope assisted small incision group,the differences were statistically significant（ P〈0. 05）. About thyroid disease,proportion of chest discomfort,VAS pain score,length of hospital stay and postoperative cosmetic effect of satisfaction scores in complete endoscopic group were significantly higher than that of endoscopy assisted small incision group,the differences were statistically significant（ P〈0. 05）. About parathyroid disease,the age of patients in the complete endoscopic group was significantly lower than that in endoscopy assisted small incision group,but the operation time and hospital stay were significantly higher than that of endoscopy assisted small incision group,the differences were statisticall

关 键 词：全腔镜 腔镜辅助小切口术式 甲状腺手术 优劣势 

分 类 号：R615[医药卫生—外科学]