胸乳入路腔镜良性甲状腺病变手术学习曲线的研究  

Benign Thyroid Disease Surgery Learning Curves of Endoscopic Thyroidectomy via Chest-Breast

作　　者：吴维敏[1] 尹俊峰[1] 陈雪花[1] 何国平[1] 

机构地区：[1]解放军187医院普通外科,海南海口571109

出　　处：《华南国防医学杂志》2015年第8期593-595,599,共4页Military Medical Journal of South China

摘　　要：目的探讨胸乳入路腔镜甲状腺手术的学习曲线。方法回顾性分析100例胸乳入路腔镜甲状腺手术临床资料。按照手术日期先后分为5组(A、B、C、D、E),每组20例。比较各组的手术时间、出血量、病变部位、手术方式、二次手术发生率、手术中转开放率、并发症、疼痛评分、术后住院时间、切除单侧腺体大小、胸部间隙的准确率及手术频率等。结果 5组病例在年龄、性别、二次手术发生率、疼痛评分、病变部位、并发症、术后住院时间和手术方式等方面差异无统计学意义(P>0.05)。A组手术时间为(186±26)min,显著长于B组(112±34)min、C组(85±21)min、D组(77±23)min和E组(78±20)min(P<0.05);A组的术中出血量为(52±22)ml,明显多于B组(25±7)ml、C组(22±5)ml、D组(20±8)ml和E组(18±5)ml(P<0.05);手术频度由A组4.5例/月,逐渐上升到B组12例/月、C组18例/月、D组24例/月、E组20例/月;手术中转开放率A组1例、B组1例,C组0例、D组0例、E组0例。结论胸乳入路腔镜甲状腺手术的学习曲线大致为20例。Objective To explore the learning curve of endoscopic thyroidectomy via chest-breast.Methods The clinical data of 100 cases of endoscopic thyroidectomy via chest-breast approach were retrospectively analyzed.According to the surgery dates,the patients were equally divided into groups A,B,C,D and E.Comparisons were made among the five groups in operation time,blood loss,diseased region,surgical procedures,reoperation rate,rate of conversion to open surgery,postoperative complications,Postoperative pain scores,postoperative hospital stay,Single side glands size,rate of Accurate chest approach and Surgery frequency.Results No significant difference was found in age,sex,reoperation rate,postoperative pain scores,diseased region,postoperative complications,postoperative hospital stay and surgical procedures among the five groups.The operation time was significantly longer in groups A than in B,C,D and E（（186±26）min vs（112±34）min,（85±21）min,（77±23）min and（78±20）min,P〈0.05）,and blood loss in surgery was significantly more in the A group than in the latter four（（52±22）ml vs（25±7）ml,（22±5）ml,（20±8）ml and（18±5）ml;P〈0.05）.The frequency of surgery was increased from4.5 cases a month in group A to 12,18,24 and20 cases a month in B,C,D and E,while 1 patient in surgery converted to open surgery in group A,1,0,0,0case in groups B,C,D and E.Conclusion The learning curve of endoscopic thyroidectomy via chest-breast approach is about 20 cases.

关 键 词：学习曲线 胸乳入路 腔镜 甲状腺手术 

分 类 号：R653[医药卫生—外科学]